Professionals’ views on integrated care

Abstract

Purpose Integrated care policies have been at the heart of recent health reforms in many European countries. The purpose of this paper is to study the integration from the perspective of health care personnel working in primary health care clinics. Design/methodology/approach The study employs data from interviews collected in a research project examining patient choice and integrated care in primary health care clinics in Finland. The interviews were conducted in five cities in Southern Finland in 17 primary health care clinics in Autumn 2014. Among the interviewees there were both doctors (n=32) and nurses (n=31). Findings The typical problems hindering integration were, according to the workers, poor communication and insufficient information exchange between professionals, unclear definition of responsibilities between professionals, and lacking contacts and information exchange between health and social care professionals. To secure availability and continuity of care, doctors and nurses did extra work and exceeded their duties or invented ad hoc solutions to solve the problem at hand. According to professionals, patients were forced to take an active role as coordinator of their own care when responsibilities were not clearly defined between professionals. Originality/value This paper highlights that successful integration requires taking into account the requirements of the day-to-day work of health care clinics, and clarifying what facilitates and what hinders practical collaboration between different actors in health care and between health care and other service providers.

Partnership working across sectors: a multi-professional perspective

“…Information sharing, trust and acknowledging the skills and capabilities of sectors were mutual findings. The importance of information exchange and communication further concurs with the study by Jolanki et al (2017). This was particularly the case about knowledge and access to third sector servicesrespondents simply highlighted that they did not know how or where to access information, and that clarity and communication of offerings were simply required.…”

Experienced time pressure and stress: electronic health records usability and information technology competence play a role

“…Digital competence comprises not only IT skills but also the ability to meet complex demands using psychosocial resources (including skills and attitudes) in a particular circumstance [5]. For patients with multiple care needs, nurses should tailor care between social care and healthcare [42, 43]. In these situations, a fluent exchange of information between professionals and organizations is important for care continuity.…”

Competence needs of integrated care in the transition of health care and social services in Finland

“…10,11 Therefore, it is important to identify novel competences required to overcome present inadequacies, such as poor communication, "silo" thinking and unclear responsibilities, that hinder care integration. 1 For example, Jolanki et al 1 found that patients in health care clinics were forced to take an active role as the coordinator of their care, which is in contradiction with the idea of peoplecentered care. 7 In line with previous scarce research, a recent report 12 emphasizes generic competences learned and shared by all professional groups as a prerequisite for successful reform.…”