Priority setting and cross-country learning: the relevance of TO-REACH for primary care

To inform the primary care community about priorities for research in primary care as came up from the European project TO-REACH and to discuss transferability of service and policy innovations between countries. The large variation in service organisation and policy around primary care in Europe is a huge potential for cross-country learning. 

TO-REACH stands for Transfer of Organizational innovations for Resilient, Effective, equitable, Accessible, sustainable and Comprehensive Health services and systems.

In safe hands: a qualitative study on older adults’ experiences of a tailored primary health care unit

Today’s health care system faces challenges in meeting the needs of older people with multimorbidity. To better cope with these needs, tailored primary health care with geriatric competence and person-centred care has been suggested. The aim of this study was to explore older patients’ experiences of a tailored primary health care unit.

Person-centred care in primary care: What works for whom, how and in what circumstances?

This rapid realist review aims to explain how and why person-centred care (PCC) in primary care works (or not) among others for people with low health literacy skills and for people with a diverse ethnic and socioeconomic background, and to construct a middle-range programme theory (PT). The middle-range PT demonstrates that healthcare professionals (HCPs) should be trained and equipped with the knowledge and skills to communicate effectively (i.e. in easy-to-understand words, emphatically, checking whether the patient understands everything, listening attentively) tailored to the wishes, needs and possibilities of the patient, which may lead to higher satisfaction.

Emergency Room Nurses’ Experiences in Person-Centred Care

Implementing person-centred care is often considered difficult in congested emergency rooms. The purpose of this study was to understand person-centred care experienced by emergency room nurses in depth and examine the essence of emergency room nurses’ lived experience of the person- centred care.

Transforming Primary Care in New York Through Patient-Centered Medical Homes: Findings From Qualitative Research

he patient-centered medical home (PCMH) model, an important component of healthcare transformation in the United States, is an approach to primary care delivery with the goal of improving population health and the patient care experience while reducing costs. PCMH research most often focuses on system level indicators including healthcare use and cost; descriptions of patient and provider experience with PCMH are relatively sparse and commonly limited in scope. This study, part of a mixed-methods evaluation of a multi-year New York State initiative to refine and expand the PCMH model, describes patient and provider experience with New York State PCMH and ...

District nurses' perspectives on health-promotive and disease-preventive work at primary health care centres: A qualitative study

Health promotion and disease prevention are of utmost importance for sustainable health care and primary health care. District nurses play a key role in primary health care centres, where they meet people suffering from, and/or having risk factors for, non-communicable diseases.

he district nurses described health-promotive endeavours, in line with person-centred care in prioritising building relationships with patients, starting from their lived experience. They spoke of barriers, at both micro and macro levels, to health-promotive/disease-preventive work. These included language barriers, the impact of the media, and the overall organisation of primary health care. 

Factors influencing the implementation of person-centred care in nursing homes by practice development champions: a qualitative process evaluation of a cluster-randomised controlled trial (EPCentCare) using Normalization Process Theory

Person-centred care (PCC) has been suggested as the preferred model of dementia care in all settings. The EPCentCare study showed that an adapted PCC approach was difficult to implement and had no effect on prescription of antipsychotics in nursing home residents in Germany. This paper reports the qualitative process evaluation to identify facilitators and barriers of the implementation of PCC in German nursing homes from the perspective of participating practice development champions.

The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study

An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as ...

Development and Implementation of an Integrated Care Fellowship

Integrated care is a common approach to leverage scarce psychiatric resources to deliver mental health care in primary care settings. The Integrated Care clinical fellowship serves as a model for training programs seeking to provide training in clinical and systems-based skills needed for practicing integrated care. Whether such training is undertaken as a standalone fellowship or incorporated into existing consultation-liaison psychiatry programs, such skills are increasingly valuable as integrated care becomes commonplace in practice.  

Adoption and Initial Implementation of a National Integrated Care Programme for Diabetes: A Realist Evaluation

The implementation of models of integrated care for chronic conditions is not well understood. We conducted a realist evaluation to determine how and why the implementation of the National Diabetes Programme in Ireland worked (or not). This study showed that, locally important contexts facilitating implementation included staff experience of delivering diabetes care, capacity, and familiarity with the intended purpose of new clinical posts. The extent to which integrated care was adopted and implemented depended on judgements made by professionals working in these contexts; specifically, judging the relative advantage of the programme and whether to engage in negotiations to legitimize their ...