Connecting Care in the Community: what works and what doesn't

Abstract

As the burden of chronic and complex disease grows, there is an emphasis on programs that enhance the quality of care within primary care. The Connecting Care in the Community (CCC) program is an example of the implementation of care integration. This qualitative study sought to explore the experiences general practice staff face in managing clients with chronic and complex care issues, and their perceptions of the contribution of the CCC program to this care. Seventeen general practice staff from 11 practices throughout the Illawarra/Shoalhaven region participated in semistructured interviews. Five main themes emerged: (1) awareness of the CCC program; (2) varying program exposure and value placed on the program; (3) practice 'busyness' and role confusion; (4) communication and information sharing; and (5) the need for staff education and knowledge of local resources. If policymakers and healthcare organisations can gain a better understanding of the experiences of general practice staff, they will be able to design and implement programs that best meet the needs of the providers that they are attempting to integrate. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences What is known about this topic? The integration of care has the potential to improve outcomes for people with chronic disease, as well as optimise the utilisation of finite health resources. What does this paper add? The success of care coordination programs is dependent upon a range of factors beyond the clinical efficacy of the intervention. Recognising and addressing these factors will enhance the uptake of these programs and allow better evaluation of their effectiveness. AbstractAs the burden of chronic and complex disease grows there is an emphasis on programs which enhance the quality of care within primary care. The Connecting Care in the Community (CCC) program is one example of care integration that has been implemented. This qualitative study sought to explore the experiences general practice staff face in managing clients with chronic and complex care issues and their perceptions of the contribution of the CCC program to this care. Seventeen general practice staff from 11 Practices throughout the Illawarra/Shoalhaven region participated in semi-structured interviews. Five main themes emerged, namely; (1) Awareness of the CCC program, (2) varying program exposure and value placed on the program, (3) Practice 'busyness' and role confusion, (4) communication and information sharing, and (5) the need for staff education and knowledge of local resources. Better understanding the experiences of general practice staff will allow policy makers and health care organisations to design and 2 implement programs that best meet the needs of the providers that they are attempting to integrate.

Key stakeholder experiences of an integrated healthcare pilot in Australia: a thematic analysis

“…The need for managing chronic illness in the community is documented [49,52], and we noted the importance of a well-supported primary care sector as part of an effective integrated care model. This included providing GP teams with information about patient management through case conferencing and consultation with hospital specialists in the RASS clinics.…”

Key stakeholder experiences of an integrated healthcare pilot in Australia: A thematic analysis

“…The need for managing chronic illness in the community is documented (47,50), and we noted the importance of a well-supported primary care sector as part of an effective integrated care model. This included providing GP teams with information about patient management through case conferencing and consultation with hospital specialists in the RASS clinics.…”

Impact of externally facilitated continuous quality improvement cohorts on Advanced Access to support primary healthcare teams: protocol for a quasi-randomized cluster trial

“…While CQI fosters the adoption of evidence-based practices [ 20 ] and is instrumental to achieve the quintuple aim, multiple strategies have been used to support organisational change [ 23 , 24 ]. Despite emerging evidence on the influence of the implementation context on the outcomes of CQI [ 25 , 26 ], such as managerial involvement [ 27 ], staff attitudes [ 27 – 29 ], interprofessional collaboration [ 28 ], effective communication [ 28 ], the presence of an internal champion [ 27 ], available resources [ 28 ], general QI culture [ 30 ], the absence of conflict [ 27 ], the QI objective itself [ 30 ] and fit with the organisation’s priorities [ 30 ], knowledge gaps remain, especially about the ideal team size and composition, optimal levels of patient involvement [ 31 – 33 ], and more importantly, the mechanisms [ 34 – 36 ] by which QI happens.…”