Trane Kristin, Aasbrenn Kristian, Rønningen Martin, Odden Sigrun, Lexén Annika, Landheim Anne
Inland hospital trust, NO.
Inland Norway University of Applied Sciences, NO.
Int J Integr Care. 2022 May 25;22(2):17. doi: 10.5334/ijic.6011. eCollection 2022 Apr-Jun.
To provide more integrated care, several countries have implemented the Flexible Assertive Community Treatment (FACT) model. However, this model does not guarantee full integration, especially in complex and fragmented service systems like in Norway. Hence, we investigated which barriers that might reduce the potential for integrated care in the Norwegian system, as described by staff in FACT teams, and how they adjust their way of working to increase the opportunities for integration.
Online focus group interviews involving 35 staff members of five Norwegian FACT teams were conducted using a semi-structured interview guide. The material was analysed using thematic text analysis.
Six themes described the barriers to integrated care in the service system: fragmentation, different legislation and digital systems, challenges in collaboration, bureaucracy and limited opening hours. Three themes described adjustments in the teams' way of working to enhance integration: working as the responsible co-ordinator, being a collaborator, and the only entry channel into the service system.
The FACT team staff described several barriers to integration within the system. However, they made some adjustments in their way of working that might provide opportunities for integrated care within complex and fragmented service systems.
为了提供更综合的护理，几个国家实施了灵活主动社区治疗（FACT）模式。然而，这种模式并不能保证完全整合，尤其是在挪威这样复杂且分散的服务体系中。因此，我们调查了挪威系统中可能会降低综合护理潜力的障碍（如FACT团队工作人员所述），以及他们如何调整工作方式以增加整合机会。
使用半结构化访谈指南，对挪威五个FACT团队的35名工作人员进行了在线焦点小组访谈。采用主题文本分析法对材料进行分析。
六个主题描述了服务系统中综合护理的障碍：分散、不同的法规和数字系统、协作挑战、官僚作风和营业时间有限。三个主题描述了团队为加强整合而进行的工作方式调整：担任责任协调员、成为合作者以及作为服务系统的唯一入口渠道。
FACT团队工作人员描述了系统内整合的几个障碍。然而，他们在工作方式上做出了一些调整，这可能为复杂且分散的服务系统中的综合护理提供机会。
