The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals

Sales, Anne E.; Pineros, Sandra; Magid, David J.; Every, Nathan R.; Sharp, Nancy; Rumsfeld, John S.

doi:10.1186/1472-6963-5-2

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…This study advances the literature on clinical integration and coordination in primary care [ 6 , 11 , 29 – 33 ]. Coordination is an important dimension of primary care practice [ 34 ].…”

Section: Discussionmentioning

confidence: 52%

How personal and standardized coordination impact implementation of integrated care

Benzer

Cramer

Burgess

et al. 2015

BMC Health Serv Res

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BackgroundIntegrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care.MethodsSemi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations.ResultsInterviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures.DiscussionThis study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation.ConclusionIntegrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.

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“…This study advances the literature on clinical integration and coordination in primary care [ 6 , 11 , 29 – 33 ]. Coordination is an important dimension of primary care practice [ 34 ].…”

Section: Discussionmentioning

confidence: 52%

How personal and standardized coordination impact implementation of integrated care

Benzer

Cramer

Burgess

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

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“…[ 14 19 20 22 25 28 ] Similarly, in the in-person visits to health centers, nursing staff and health liaisons, as coordinators of the referral system in health centers, play a role in the effective performance of the referral system. [ 22 27 32 ]…”

Section: Resultsmentioning

confidence: 99%

“…Supply of human resources at the primary care level for screening, disease diagnosis, and counseling for referral to the specialized level, as well as a sufficient number of health and treatment centers, hospitals and specialized clinics, and treatment facilities involved in providing health services to veterans, are among the referral system's operational components. [ 28 27 30 32 ] In some studies, the financing of referral services is one of the obstacles to receiving services for referred patients. Therefore, the certainty of providing financial resources for referral can be an incentive for the service provider and a factor in facilitating veterans’ access to health services.…”

Section: Resultsmentioning

confidence: 99%

Identification of the factors affecting the referral system of veterans' health services: A scoping review

Taymournejad,

Hosseini,

Jafari

et al. 2023

Journal of Education and Health Promotion

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Referral in the health system is a systematic process for the optimal allocation of resources and improves the access of people in need of treatment services. Considering the vulnerability of the veterans and more medical needs in this group, this study aims to identify the components that affect veterans’ health services referral system. MEDLINE, Scopus, Web of Science, and ProQuest databases, the international military studies website, and key journals in the field of veterans’ health services were searched with related keywords including “veteran,” “referral system,” and “health services” for the period from January 2000 to July 2022. Studies were screened and selected in accordance with the phases of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) flow diagram 2020. Data extraction was done by two researchers independently and a thematic content analysis method was used to analyze the findings. Among 40,608 studies searched electronically and 16 studies searched manually, 19 studies that met the inclusion criteria were selected. The research method applied here is a combination of quantitative, qualitative, and mixed methods. The most important findings were extracted from the included studies and analyzed in three general categories: components related to the patient, service provider, and the structural-operational mechanisms of the referral system. The effective performance of the referral system for providing health services to veterans is influenced by the factors affecting components related to the patient, the service provider, and the structural-operational mechanisms of the referral system. Evaluating and improving each of these factors improve the performance of the referral system and provision of health services to veterans.

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The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals

Cited by 2 publications

References 25 publications

How personal and standardized coordination impact implementation of integrated care

How personal and standardized coordination impact implementation of integrated care

Identification of the factors affecting the referral system of veterans' health services: A scoping review

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