Barriers to Integration of Primary Care into Emergency Care: Experiences in Germany

Dickinson, Andrew; Joos, Stefanie

doi:10.5334/ijic.5442

Cited by 6 publications

(5 citation statements)

References 30 publications

(39 reference statements)

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“…In recent years, scholars in the field of integrated care have reported under what circumstances collaboration turned out to be effective. For instance, the formulation of shared goals among actors [22,27], leaders who emphasize collaboration [80], joint working spaces [74], and joint funding [6,7,26] have been identified as enablers of collaboration. Our conceptual framework increases understanding of why precisely collaboration was enhanced under these circumstances.…”

Section: Discussionmentioning

confidence: 99%

“…Third, location matters. Dickinson and Joos [74] have shown how the layout of a hospital complex affected collaboration. Specifically, they have shown that the physical separation between actors, as they were based in different buildings, contributed to an atmosphere that was observed to be strained and consisted of stark interprofessional borders.…”

Section: Situation-based Antecedents That Influence Social Motivationmentioning

confidence: 99%

“…In fact, by making the motivations and perspectives underlying behavior in the process of integrating care, as well as the person-and situation-based antecedents of these, explicit (see Figure 1), our framework shows that it remains just as important for actors, such as leaders, to tackle well-known barriers to integrated care. Limited time and resources and a lack of shared goals [6,74], among others, may hamper actors' ability to demonstrate the three behaviours that have been shown to be conducive to collaboration. For instance, time constraints may hinder actors' ability to exhibit voice behaviour, and to listen to and process information shared by others.…”

Section: Focal Points When Integrating Care Servicesmentioning

confidence: 99%

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From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

Kee,

Nies,

van Wieringen

et al. 2023

International Journal of Integrated Care

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Introduction: At all levels, effective collaboration between actors with different backgrounds lies at the heart of integrated care. Much attention has been given to the structural features underlying integrated care, but even under structurally similar circumstances, the effectiveness of collaboration varies largely.Theory and methods: Social and organizational psychological research shows that the extent to which collaboration is effective depends on actors' behaviours. We leverage insights from these two research fields and build a conceptual framework that helps untangle the behavioural processes underlying effective collaboration. Results:We delineate that effective collaboration can be realized when actors (1) speak up about their interests, values, and perspectives (voice behaviour), (2) listen to the information that is shared by others, and (3) thoroughly process this information. We describe these behaviours and explain the motivations and conditions driving these. In doing so, we offer a conceptual framework that can be used to explain what makes actors collaborate effectively and how collaboration can be enhanced. Discussion and conclusion:Fostering effective collaboration takes time and adequate conditions, fitting the particular context. As this context continuously changes, the processes and conditions require continuous attention. Integrated care, therefore, actually requires a carefully designed process of integrating care.

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Section: Discussionmentioning

confidence: 99%

Section: Situation-based Antecedents That Influence Social Motivationmentioning

confidence: 99%

Section: Focal Points When Integrating Care Servicesmentioning

confidence: 99%

See 1 more Smart Citation

From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

Kee,

Nies,

van Wieringen

et al. 2023

International Journal of Integrated Care

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“…Interpersonal and normative types of integration describe the social features closely related to stakeholders’ beliefs and behaviour [ 11 ]. However, only a handful of studies [ 12 – 14 ] have examined them in healthcare contexts since the concept is challenging to investigate [ 15 – 17 ]. Therefore, this study’s objective is to explore the concept of integration among GPs and the PCN representatives from the RHS in a GP-RHS PCN and their perceived partnership success.…”

Section: Introductionmentioning

confidence: 99%

Developing integration among stakeholders in the primary care networks of Singapore: a qualitative study

Surendran

Foo

Matchar

et al. 2022

BMC Health Serv Res

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Background Integrating healthcare services across and between the different health system levels can be achieved in a few ways; however, examining the social side of integration is essential and challenging. This paper explores the concept of integration perceived by general practitioners (GPs) and primary care network (PCN) representatives from the regional health systems (RHS) in a GP-RHS PCN and their perceived partnership success. Methods In this study, we explored three GP-RHS PCNs in Singapore. We used a qualitative research design and, overall, performed 17 semi-structured in-depth interviews with GPs (n = 11) and PCN representatives (n = 6) from the RHS. All interviews were audiotaped and transcribed verbatim. We conducted thematic analysis to inductively identify themes from the data. Singer's conceptual model of integration types was used as guiding principles to derive relevant and salient themes for integration. Results GPs and the RHS perceived the concept of integration through a series of interrelated strategies. Within the normative dimension, a sense of urgency motivated GPs to integrate improvements into their general practice. Participants perceived teamwork and relational climate as appropriate enablers for achieving interpersonal integration in a primary care partnership. While developing a trusted relationship was a perceived success of this partnership across the network, developing camaraderie and gaining knowledge in chronic disease management through the components of functional integration was a perceived success at an individual general practice level. The data also revealed some operational challenges within the structural dimension and some inabilities of the PCN to achieve complete process integration. Conclusions Our study points to multi-faceted integration, comprising various forms that need to be manifested at all levels of care to achieve coordinated, seamless, and comprehensive care for patients suffering from chronic conditions. The present iteration of the PCN has been shown to offer integration at a level that warrants praise but still requires structural and process integration improvement.

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“…The key features of the RMIC are organised into eight main dimensions, which are contained in three categories: scope (person focused or population based), type (clinical, professional, organisational and system) and enablers (functional or normative) of an integrated primary care service model 12. The RMIC provides a mechanism to describe key features of care integration across a range of populations 13 14…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of community-based multidisciplinary integrated care for older people: a protocol for a systematic review

et al. 2022

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IntroductionThe increasing number of older adults with multiple complex care needs has placed increased pressure on healthcare systems internationally to reorientate healthcare delivery. For many older adults, their first point of contact with the health service is with their general practitioner (GP) and GP participation with integrated care models is the foundation of a population-based approach. A knowledge gap remains in relation to the effectiveness of GP participation in community-based integrated health and social care approaches for older adults. This systematic review aims to examine the effectiveness of multidisciplinary-integrated care for community-dwelling older adults with GP participation.Methods and analysisThis systematic review will include randomised controlled trials (RCTs), quasi and cluster RCTs focusing on integrated care interventions for community-dwelling older adults by multidisciplinary teams including health and social care professionals and GPs. The databases PUBMED, EMBASE, CINAHL, Central Register of Controlled Trials in the Cochrane Library and MEDLINE will be searched. The primary outcome measure will be functional status. Secondary outcomes will include: primary healthcare utilisation, secondary healthcare utilisation, participant satisfaction with care, health-related quality of life, nursing home admission and mortality. The methodological quality of the studies will be assessed using the Cochrane Risk of Bias Tool V.2. The elements of care integration will be mapped in the individual studies using the Rainbow Model of Integrated Care taxonomy. A meta-analysis will be completed, depending on the uniformity of the data. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the certainty of evidence.Ethics and disseminationFormal ethical approval is not required as all data included are anonymous secondary data. Scientific outputs will be presented at relevant conferences and in collaboration with our public and patient involvement stakeholder panel of older adults at the Ageing Research Centre at the University of Limerick.PROSPERO registration numberCRD42022309744.

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Barriers to Integration of Primary Care into Emergency Care: Experiences in Germany

Cited by 6 publications

References 30 publications

From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

Developing integration among stakeholders in the primary care networks of Singapore: a qualitative study

Effectiveness of community-based multidisciplinary integrated care for older people: a protocol for a systematic review

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