Fuller Jeffrey, Oster Candice, Dawson Suzanne, O'Kane Deb, Lawn Sharon, Henderson Julie, Gerace Adam, Reed Richard, Nosworthy Ann, Galley Philip, McPhail Ruth, Cochrane Eimear Muir
School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
School of Medicine, Flinders University, Adelaide, Australia.
BMJ Open. 2014 Sep 16;4(9):e006304. doi: 10.1136/bmjopen-2014-006304.
An integrated approach to the mental healthcare of older people is advocated across health, aged care and social care sectors. It is not clear, however, how the management of integrated servicing should occur, although interorganisational relations theory suggests a reflective network approach using evaluation feedback. This research will test a network management approach to help regional primary healthcare organisations improve mental health service integration.
This mixed methods case study in rural South Australia will test facilitated reflection within a network of health and social care services to determine if this leads to improved integration. Engagement of services will occur through a governance group and a series of three 1-day service stakeholder workshops. Facilitated reflection and evaluation feedback will use information from a review of health sector and local operational policies, a network survey about current service links, gaps and enablers and interviews with older people and their carers about their help seeking journeys. Quantitative and qualitative analysis will describe the policy enablers and explore the current and ideal links between services. The facilitated reflection will be developed to maximise engagement of senior management in the governance group and the service staff at the operational level in the workshops. Benefit will be assessed through indicators of improved service coordination, collective ownership of service problems, strengthened partnerships, agreed local protocols and the use of feedback for accountability.
ETHICS, BENEFITS AND DISSEMINATION: Ethics approval will deal with the sensitivities of organisational network research where data anonymity is not preserved. The benefit will be the tested utility of a facilitated reflective process for a network of health and social care services to manage linked primary mental healthcare for older people in a rural region. Dissemination will make use of the sectoral networks of the governance group.
卫生、老年护理和社会护理部门都提倡采用综合方法为老年人提供心理保健服务。然而，尽管组织间关系理论提出了一种利用评估反馈的反思性网络方法，但目前尚不清楚综合服务管理应如何开展。本研究将测试一种网络管理方法，以帮助地区初级卫生保健组织改善心理健康服务的整合。
这项在南澳大利亚农村地区开展的混合方法案例研究，将测试在卫生和社会护理服务网络内进行的促进性反思，以确定这是否会带来更好的整合效果。服务参与将通过一个治理小组和一系列为期三天的服务利益相关者研讨会来实现。促进性反思和评估反馈将利用对卫生部门和地方运营政策的审查信息、关于当前服务联系、差距和促进因素的网络调查，以及与老年人及其护理人员就其求助过程进行的访谈。定量和定性分析将描述政策促进因素，并探索服务之间的当前和理想联系。促进性反思将得到进一步发展，以最大限度地提高治理小组中高级管理人员和研讨会上运营层面服务人员的参与度。将通过服务协调改善、服务问题的集体所有权、加强伙伴关系、商定的地方协议以及利用反馈进行问责等指标来评估效益。
伦理、效益与传播：伦理批准将处理组织网络研究中数据匿名性无法保留的敏感性问题。效益将体现在经过测试的促进性反思过程对卫生和社会护理服务网络的效用上，该网络用于管理农村地区老年人的相关初级心理保健服务。传播将利用治理小组的部门网络。
