Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability.

Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. 

Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks ...

Continuity of clinical management and information across care levels: perceptions of users of different healthcare areas in the Catalan national health system

The integration of health care has become a priority in most health systems, as patients increasingly receive care from several professionals in various different settings and institutions, particularly those with chronic conditions and multi-morbidities. Continuity of care is defined as one patient experiencing care over time as connected and coherent with his or her health needs and personal circumstances. The objective is to analyse perceptions of continuity of clinical management and information across care levels and the factors influencing it, from the viewpoint of users of the Catalan national health system.

Evolving Concepts of Patient-Centered Care and the Assessment of Patient Care Experiences: Optimism and Opposition

This article summarise, a personal view of the author (Paul D. Cleary dean of the Yale School of Public Health), on the available research, concerning measurement of “patient satisfaction” and “patient care experience”. Author argues that patient experiences measurement efforts are being devoted to providing high-quality patient-centered care. Some indicators and surveys are discussed in terms of their reliability, validity and correlation across individuals and settings with other quality indicators.

Special attention is paid to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), launched in 1995 by the Agency for Healthcare Research and Quality (AHRQ). The CAHPS surveys are ...

Healthy China : deepening health reform in China building high-quality and value-based service delivery

As many other countries, China faces big challenges to meet the health care needs of her citizens, associated with a rapidly aging society and increasing burden of non-communicable diseases (NCDs). Also, health costs have been growing at a rate higher than GDP growth since 2008.

Since the launch of health reform in 2009, China has invested significantly in health infrastructure at the grassroots level and made progress in building the primary care doctors system. Basic public health services capacity has been significantly enhanced. China is progressing quickly to achieving universal health coverage and some of the reform achievements have attracted ...

Power and Integrated Health Care: Shifting from Governance to Governmentality

Integrated care occurs within micro, meso and macro levels of governance structures, which are shaped by complex power dynamics. Yet theoretically-led notions of power, and scrutiny of its meanings and its functioning, are neglected in the literature on integrated care. We explore an alternative approach. Following a discussion on governance, two streams of theorising power are presented: mainstream and second-stream. Mainstream concepts are based on the notion of power-as-capacity, of one agent ­having the capacity to influence another—so the overall idea is ‘power over ’. Studies on integrated care ­typically employ mainstream ideas, which yield rather limited analyses. Second-stream concepts ...

Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches

This guide outlines how the science of behaviour can help people to self-manage their health and wellbeing.

Key findings

• The guide uses the EAST framework to organise ideas and examples. The core message of EAST is that if you want to encourage a behaviour, you should make it Easy, Attractive, Social and Timely.
• The guide features a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes.

This action-focused guide is part of the NHS England-funded Realising the Value programme, which seeks to develop person- and community-centred approaches for health ...

Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing

This guide outlines how behavioural science can help spread the take-up of person- and community-centred approaches to health and wellbeing.

Key findings

•     The guide uses the EAST framework to organise ideas and examples. The core message of EAST is that if you want to encourage a behaviour, you should make it Easy, Attractive, Social and Timely.
•     The guide features a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes.

This action-focused guide is part of the NHS England-funded Realising the Value programme, which seeks to develop person- and community-centred ...

Elaboration of the Gothenburg model of person-centred care

OBJECTIVE:

In this paper, it is aimed to explore professionals understanding of PCC routines as they implement the GPCC model in a range of different settings.

METHODS:

It is conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects.

RESULTS:

Interviewees accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.

CONCLUSION:

This study illustrates what is needed for health-care professionals to implement PCC ...

Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes.

Effect of care management program structure on implementation: a normalization process theory analysis

Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice.