System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

Passalent, Laura; Kennedy, Carol; Warmington, Kelly; Soever, Leslie; Lundon, Katie; Shupak, Rachel; Lineker, Sydney; Schneider, Rayfel

doi:10.12927/hcpol.2013.23396

Cited by 17 publications

(24 citation statements)

References 34 publications

(62 reference statements)

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“…Most instruments are questionnaires and were created or tested in a health care setting or with health-related outcomes. Intersectoral coordination is captured by variables such as: connections between partnering organizations [47484950]; social networks [5152]; interagency linkages [53545556]; depth of integration [5758]; and level of system integration and change [59]. Morrissey et al 1994 [51] developed two instruments appropriate for this domain.…”

Section: Resultsmentioning

confidence: 99%

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Suter¹,

Oelke²,

Lima³

et al. 2017

Int J Integr Care

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Background:Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care.Methods:We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools.Findings:From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains.Discussion:Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, “overall integration” tools may be useful for a broad assessment of the overall state of a system.Conclusions:Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.

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Section: Resultsmentioning

confidence: 99%

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Suter¹,

Oelke²,

Lima³

et al. 2017

Int J Integr Care

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“…The majority of literature related to physiotherapy ESP, which is similar to the findings of McPherson et al; however, there were no randomized controlled trials as originally recommended. The literature included cohort studies, 20 – 22 , 27 – 31 surveys reporting tasks undertaken, 12 , 32 – 38 and a number of systematic reviews relating to orthopedic outpatients 13 , 18 , 39 or inflammatory conditions. 40 Only one article reported on a pre–post impact that included patient outcomes.…”

Section: Resultsmentioning

confidence: 99%

Extended roles for allied health professionals: an updated systematic review of the evidence

Saxon¹,

Gray²,

Oprescu³

2014

JMDH

122

114

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BackgroundInternationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services.MethodsA systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction.ResultsA total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review.ConclusionLiterature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer-accepted investment that health services can make to improve patient outcomes.

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“…In response to the problem of access to rheumatologic care, clinicians' organizations and others have advocated for new models of care with ERP, including physiotherapists 10 , and training programs have also been developed such as the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program in Toronto (Ontario, Canada) to train physiotherapists and occupational therapists to act as ERP in rheumatology settings 11 . To date, studies have examined and described the role of ERP in managing patients with inflammatory arthropathies, but have failed to examine agreement between ERP and physicians or the efficiency of these models 12,13 . Studies that compared interobserver agreement between ERP and physicians for musculoskeletal disorders have mostly been conducted in orthopedic settings 8,14 .…”

Section: Editorialmentioning

confidence: 99%

Extended Role Practitioners to Improve Access to Rheumatic Care: What is the Evidence in the Classification of Patients with Spondyloarthritis?

Lowry

Desmeules

2020

J Rheumatol

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System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

Cited by 17 publications

References 34 publications

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Extended roles for allied health professionals: an updated systematic review of the evidence

Extended Role Practitioners to Improve Access to Rheumatic Care: What is the Evidence in the Classification of Patients with Spondyloarthritis?

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