Hamdani Yani, Proulx Meghann, Kingsnorth Shauna, Lindsay Sally, Maxwell Joanne, Colantonio Angela, Macarthur Colin, Bayley Mark
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.
Bloorview Research Institute, Toronto, Canada.
J Pediatr Rehabil Med. 2014;7(1):79-91. doi: 10.3233/PRM-140271.
LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities.
This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework.
Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services.
LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.
“生命跨度”（LIFEspan）是一种由一家儿科康复医院和一家成人康复医院跨组织合作开发并实施的持续协调护理服务提供模式。此前的工作探讨了建立伙伴关系服务的促进因素和障碍。本文考察了医疗保健专业人员（HCPs）在“现实世界”中提供旨在支持残疾青年过渡性康复护理服务方面的经验。
这项定性研究——正在进行的混合方法纵向研究的一部分——通过深入访谈引出了HCPs对他们在“生命跨度”服务提供方面经验的看法。数据被归类为服务提供活动的主题，然后从服务整合/协调框架的角度进行解读。
确定了五个主要的服务提供主题：1）解决青年的过渡准备情况和能力问题；2）将医疗保健管理的责任从父母转移到青年；3）根据组织资源确定服务；4）儿科和成人康复服务之间的联系；以及5）与多部门服务建立联系。
“生命跨度”有助于开展为青年和家庭协调护理并整合医院间服务的服务提供活动。然而，与初级保健、教育、社会和社区服务的服务整合差距将协调护理限制在了康复部门。建议采用基于系统/部门的方法来加强服务提供。
