Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers

Lau, Janice Y.C.; Wong, Eliza Lai-Yi; Chung, Ronald; Law, Stephen C.K.; Threapleton, Diane; Kiang, Nicole; Chau, Patsy Yuen-Kwan; Wong, Samuel Yeung‐Shan; Woo, Jean; Yeoh, Eng‐Kiong

doi:10.1002/hpm.2534

Cited by 25 publications

(29 citation statements)

References 30 publications

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“…Concerns of negatively impacting quality of care when following established structures, are also expressed in this study, urging towards structural changes in future. This is in line with the literature on the importance of care integration to improve channels of communication between providers and generate better care outcomes, also through user empowerment [23][24][25].…”

Section: Integration Coordination and Cooperation Across Ltc Structusupporting

confidence: 88%

The future of long-term care in ten European countries: Review of policy reports and qualitative study among country experts

Praznovszky¹,

Pavlova²,

Tambor³

et al. 2019

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Section: Integration Coordination and Cooperation Across Ltc Structusupporting

confidence: 88%

The future of long-term care in ten European countries: Review of policy reports and qualitative study among country experts

Praznovszky¹,

Pavlova²,

Tambor³

et al. 2019

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“…In summary, although there were various practices and providers of EOL care in Hong Kong, as summarized in the Introduction section, there is no overarching policy framework related to EOL care that conceptualizes and clarifies patients’ and their family members’ holistic needs, and how they could be provided with a comprehensive system of care. An advantage of the present study is that it extended from previous works that focused primarily on perspectives from the care providers [ 33 , 34 ]. While there are consistent findings, the present study also encompasses opinions and observations of other major stakeholders of EOL care including the non-care providers.…”

Section: Discussionmentioning

confidence: 99%

Examining the Gaps and Issues of End-of-Life Care among Older Population through the Lens of Socioecological Model—A Multi-Method Qualitative Study of Hong Kong

Chung

Dong

Chau

et al. 2020

IJERPH

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End-of-life (EOL) care for terminal illness and life-limiting conditions is a sector in the health service spectrum that is drawing increased attention. Despite having the world’s longest life expectancy and an ever-escalating demand for long-term care, Hong Kong’s EOL care was underdeveloped. The current study aims to provide a holistic picture of gaps and issues to EOL care in Hong Kong. Data collection was conducted using a multi-method qualitative approach that included focus groups and in-depth interviews with key informants and stakeholders, and longitudinal case studies with patients and families. Deductive thematic analysis was used to examine service gaps in current EOL care through the lens of a socioecological model where gaps and issues in various nested, hierarchical levels of care as well as the relationships between these levels were studied in detail. Using the model, we identified gaps and issues of EOL care among older populations in Hong Kong at the policy, legal, community, institutional, as well as intrapersonal and interpersonal levels. These include but are not limited to a lack of overarching EOL care policy framework, ambiguity in the legal basis for mental incapacity, legislative barriers for advance directives, inadequate capacity, resources, and support in the community to administer EOL care, inadequate knowledge, training, and resources for EOL care in health and social care sectors, inadequate medical-social interface, general reluctance and fear of death and dying, as well as the cultural interpretation of filial piety that may lengthen the suffering of the dying patients. Findings highlight the multi-level gaps and issues of EOL care in a place where western and eastern culture meet, and shed light on how best to design more effective and comprehensive policy interventions that will likely have a more sustainable and instrumental impact on facilitating person-centered EOL care during the end of life.

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“…They found that divergent perceptions of collaboration hindered collaboration between different policy sectors. Diverging perceptions, especially connected to ownership, were also noted as a problem in a recent study focusing on collaboration between health care and social care for elderly populations . They identified different perceptions of ownership as one of the barriers hindering collaboration; these differences were particularly linked to the different values and understandings of the different professions in the different sectors.…”

Section: Discussionmentioning

confidence: 89%

Collaboration for drug prevention: Is it possible in a “siloed” governmental structure?

Oldeide

Fosse

Holsen

2019

Health Planning & Management

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Summary Purpose Norwegian municipalities report that drug misuse is the most important public health challenge. The municipalities play a unique role in drug prevention aimed at youth, since young people rely on several services in their daily lives that are organized by different municipal departments. However, the municipal structure is described as siloed, and the policy areas as differentiated. This situation has led to a need for integration between different policy sectors to prevent drug use and promote health. The following study explores how policymakers describe the structures for integration within local government in practice with regard to drug prevention aimed at youth, contributing to the ongoing debate on collaboration and integration in response to public health challenges. Methods A single case study design was used to investigate the accounts of policymakers from different municipal departments in a Norwegian municipality following Axelsson and Axelsson's conceptual scheme of integration. Findings Collaboration between departments was viewed as important to successfully address drug prevention; however, the policymakers recognized problems with integration. The participants described confusion regarding ownership between the departments and a perceived lack of a mandate for collaboration. Conclusions The findings and discussion illustrate that integration of drug prevention in a siloed structure relies on departments appreciating their respective roles in drug prevention and advisers experiencing a mandate to manage the siloes that exist in the organization. By gaining a better understanding of the siloed structures, we can provide valuable information needed to navigate them.

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Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers

Abstract: Health care and social care service providers recognise the need for collaborative work to enhance continuity of care and ageing in place; however, their efforts are hindered by the identified barriers that need to be dealt with in practical terms and by a change of policy.

Cited by 25 publications

References 30 publications

The future of long-term care in ten European countries: Review of policy reports and qualitative study among country experts

The future of long-term care in ten European countries: Review of policy reports and qualitative study among country experts

Examining the Gaps and Issues of End-of-Life Care among Older Population through the Lens of Socioecological Model—A Multi-Method Qualitative Study of Hong Kong

Collaboration for drug prevention: Is it possible in a “siloed” governmental structure?

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