London School of Hygiene and Tropical Medicine, London, UK.
University College London Manchester, London, UK.
Health Soc Care Community. 2022 Feb;30(2):e388-e396. doi: 10.1111/hsc.13211. Epub 2020 Nov 5.
In an attempt to support care integration that promotes joined up service provision and patient-centred care across care boundaries, local health and social care organisations have embarked on several initiatives and approaches. A key component of service integration is the co-location of different professional groups. In this study, we consider the extent to which co-location is an enabler for service integration by examining multi-professional community care teams. The study presents findings from a qualitative evaluation of integrated care initiatives in a borough of East London, England, undertaken between 2017 and 2018. The evaluation employed a participatory approach, the Researcher-in-Residence model. Participant observation (n = 80 hr) and both semi-structured individual (n = 16) and group interviews (six groups, n = 17 participants) were carried out. Thematic analysis of the data was undertaken. The findings show that co-location can be an effective enabler for service integration providing a basis for joint working, fostering improved communication and information sharing if conditions such as shared information systems and professional cultures (shared beliefs and values) are met. Organisations must consider the potential barriers to service integration such as differing professional identity, limited understanding of roles and responsibilities and a lack of continuity in personnel. Co-location remains an important facet in the development of multi-professional teams and local service integration arrangements, but as yet, has not been widely acknowledged as a priority in care practice. Organisations that are committed to greying care boundaries and providing joined up patient care must ensure that sufficient focus is provided at the service delivery level and not assume that decades of silo working in health and social care and strong professional cultures will be resolved by co-location.
为了支持促进服务整合和跨越护理边界的以患者为中心的护理的一体化护理，当地的卫生和社会保健组织已经启动了若干举措和方法。服务整合的一个关键组成部分是不同专业群体的共同定位。在这项研究中，我们通过检查多专业社区护理团队，考虑共同定位是服务整合的促进因素的程度。该研究介绍了 2017 年至 2018 年期间在英格兰东伦敦一个自治市进行的综合护理计划的定性评估结果。该评估采用了参与式方法，即研究员驻留模式。参与者观察（n=80 小时）和半结构化的个人访谈（n=16）和小组访谈（六个小组，n=17 名参与者）。对数据进行了主题分析。研究结果表明，共同定位可以是服务整合的有效促进因素，如果满足共享信息系统和专业文化（共享信念和价值观）等条件，它可以为联合工作提供基础，促进更好的沟通和信息共享。组织必须考虑服务整合的潜在障碍，例如不同的专业身份、对角色和责任的有限理解以及人员的连续性不足。共同定位仍然是多专业团队和当地服务整合安排发展的一个重要方面，但迄今为止，它尚未被广泛视为护理实践的优先事项。致力于跨越护理边界和提供连贯的患者护理的组织必须确保在服务提供层面提供足够的关注，并且不要假设卫生和社会保健部门数十年来的孤立工作和强大的专业文化将通过共同定位得到解决。
