Patient autonomy in the consultation: How signalling structure can facilitate patient-centred care

This paper explores how patient autonomy may be supported or undermined in doctor-patient interactions through sharing information about what is to happen in the consultation. Doctors use a variety of verbal signalling behaviours with multiple functions. As well as sharing information, these behaviours regulate patient agency in the consultation.

The clinical effectiveness of the COPDnet integrated care model

COPD is a disease with a high prevalence in the world. Despite the great personal and family involvement, it has been seen that integrated care between hospitals and primary care translates into better clinical results for patients. Integrated care models have the potential to improve outcomes for patients with COPD. The research team design the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.

Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium

The twelve Integrated Care Program pilot projects (ICPs) created by the government plan ‘Integrated Care for Better Health’ aim to achieve four outcome types (the Quadruple Aim) for people with chronic diseases in Belgium: improved population health, improved patient and provider experiences and improved cost efficiency. The Belgian plan is based on the model of integrated care by the World Health Organization. The objective of this study is to deliver policy recommendations on strategies and best practices to improve care integration in Belgium and to implement a sustainable monitoring system that serves both policy makers and the stakeholders within the ...

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The parental perspectives on integrated Youth Care in this study emphasize that parents have a strong desire for a family-centred approach and active participation in decision making over their own care process. However, since parental expectations regarding these key components of integrated Youth Care are somewhat opposing, professionals should be aware of potential confusion and explicitly discuss mutual expectations during a care process. 

Learning from Gothenburg model of person centred healthcare

Providing person centred care is a growing imperative across healthcare. The core component of person centred care is the co-creation of care through partnership between patients, their families and carers, and health professionals. While much of the recent literature has focused on why we need to change to a more person centred approach with greater involvement of patients and the public in health and healthcare, little information is available on how to do it and whether it makes any difference. Over the past 10 years a model of person centred care has been studied and implemented in Sweden and has ...

Towards an Integrated Care Organisation from a CEO Perspective

Many experimental projects towards Person-Centred Care (PCC) are successful in the early stages, but founder when the attempt is made to scale them up to encompass the whole organisation. This case study therefore focusses on one manager’s attempts to extend the successes of a preliminary project ‘Etxean Ondo’ that aimed to provide adequate support for the elderly living at home or in nursing homes, as well as for their families and care professionals.

Collaborative Experience Success Stories in Integrated Care of Older People: A Narrative Analysis

Inter-organisational collaboration is crucial in the care of older people, as is the development of integrated care. Storytelling in organisations is one way of understanding how to achieve successful collaboration. This article provides insights into the ways in which storytelling in collaborative experiences contributes to a collective identity instrumental in the successful collaborations involved in integrated care for older people.

Understanding integrated care at the frontline using organisational learning theory: A participatory evaluation of multi-professional teams in East London

Integrated care has been proposed as an organising principle to address the challenges of the rising demand for care services and limited resources. There is limited understanding of the role of learning in integrated care systems. Organisational Learning (OL) theory in the guise of ‘Learning Practice’ can offer a lens to study service integration and reflect on some of the challenges faced by multi-professional teams in developing a learning culture.

The study presents findings from two qualitative evaluations of integrated care initiatives in three East London boroughs, England, undertaken between 2017 and 2018.

Different Contexts, Similar Challenges. SUSTAIN’s Experiences with Improving Integrated Care in Europe

SUSTAIN stands for ‘Sustainable Tailored Integrated Care for Older People in Europe’ (www.sustain-eu.org). The SUSTAIN-project was carried out between 2015 and 2019 by thirteen partners from eight European countries: Austria, Belgium, Estonia, Germany, Norway, Spain, the Netherlands, and the United Kingdom.

The SUSTAIN project was designed to support the development of integrated care for older people living at home with health and social care needs. Its objectives were twofold: 1. To support and monitor improvements to established integrated care initiatives and 2. To contribute to the adoption and application of such improvements to other health ...

The Over 75 Service: Continuity of Integrated Care for Older People in a United Kingdom Primary Care Setting

Continuity of care is concerned with quality of care over a period of time. It describes a process by which service users and their families are co-operatively involved with health and social care professionals in managing their care needs. Continuity of care can be divided into informational, managerial and relational and has been associated with improved user- and service-related outcomes. To date, there have been few studies which examine how continuity of care is developed and maintained in integrated primary care systems.