Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, AL10 9AB, UK.
BMC Health Serv Res. 2011 Dec 14;11:337. doi: 10.1186/1472-6963-11-337.
Most services provided by health and social care organisations for older people living at home rely on interprofessional working (IPW). Although there is research investigating what supports and inhibits how professionals work together, less is known about how different service models deliver care to older people and how effectiveness is measured. The aim of this study was to describe how IPW for older people living at home is delivered, enacted and evaluated in England.
An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England.
The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW. Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation) Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people.
Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may not be so necessary for the terms used to describe IPW. However, there is a need for shared identification of both user/patient outcomes that arise from IPW and greater understanding of what kind of model of IPW achieves what kind of outcomes for older people living at home.
大多数为居家老年人提供的卫生和社会保健组织服务依赖于跨专业合作（IPW）。尽管有研究调查了支持和阻碍专业人员合作的因素，但对于不同的服务模式如何为老年人提供护理以及如何衡量效果知之甚少。本研究的目的是描述英格兰居家老年人的 IPW 是如何提供、实施和评估的。
对英格兰直接参与为老年人提供服务的卫生和社会保健管理人员进行在线调查，并对英格兰初级保健组织和地方政府成人服务组织制定的老年人服务地方战略进行审查。
在线调查的回复率为 31%，搜索策略确定了 50 项针对居家老年人的跨专业合作的地方战略，这些战略涉及卫生和社会保健组织。IPW 的定义各不相同，但语言上存在一致性，这是由预算和组织对 IPW 的具体定义所决定的。社区老年人服务、中级护理和再康复（康复）团队是最常被确定涉及 IPW 的服务。其他确定的 IPW 服务是针对特定问题或疾病的，反映了地方战略中强调的问题。对于支持 IPW 过程的干预措施或策略，几乎没有达成共识。没有报告说老年人及其照顾者参与了他们所接受服务的评估，也不清楚组织和管理人员如何判断 IPW 的效果，特别是对于那些对老年人护理有无限期承诺的服务。
卫生和社会保健组织及其管理人员认识到 IPW 的价值和重要性。有关于支持 IPW 及其所能实现目标的理论文献。用于描述 IPW 的术语可能不需要如此精确，但需要共同确定源自 IPW 的用户/患者结果，并更深入地了解哪种 IPW 模式可以为居家老年人带来何种结果。
