Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark.
Department of Public Health, Research Unit of General Practice, University of Southern Denmark, J. B. Winsløws Vej 9A, 5000, Odense, Denmark.
BMC Geriatr. 2022 Jun 21;22(1):509. doi: 10.1186/s12877-022-03200-6.
The number of older people is increasing, resulting in more people endure chronic diseases, multimorbidities and complex care needs. Insufficient care coordination across healthcare sectors has negative consequences for health outcomes, costs and patient evaluation. Despite introducing initiatives to solve coordination challenges within healthcare, the need remains for more consistent solutions. In particular, improved care coordination would benefit older adults characterised by complex care needs, high use of healthcare resources and multiple care providers.
To identify and analyse healthcare professionals' perspectives and approaches to care coordination across sectors when older people are acutely hospitalised.
Qualitative interview study.
Semi-structured, individual interviews with 13 healthcare professionals across health sectors and professions were conducted. The strategy for the qualitative analysis was inspired by Kirsti Malterud and labelled 'systematic text condensation'. This strategy is a descriptive and explorative method for thematic cross-case analysis of qualitative data.
Four themes/categories emerged from the analysis; "Organisational factors", "Approaches to care", "Communication and knowledge", and "Relations".
Different organisational cultures can discourage intersectoral care coordination. Approaches to care vary at all levels across health sectors and professions. Organisational, leadership and professional identity affect the working cultures and must be considered in the future recruitment and socialisation of healthcare staff. Our research suggests that combinations of healthcare standardisations and flexible, adaptive solutions are required to improve intersectoral care coordination.
随着人口老龄化的加剧,越来越多的人患有慢性疾病、多种疾病和复杂的护理需求。医疗保健部门之间的护理协调不足对健康结果、成本和患者评估产生负面影响。尽管已经采取了一些举措来解决医疗保健内部的协调挑战,但仍需要更一致的解决方案。特别是,对于那些护理需求复杂、医疗资源使用量大和有多个护理提供者的老年人来说,改善护理协调将是有益的。
当老年人急性住院时,确定并分析医疗保健专业人员对跨部门护理协调的观点和方法。
定性访谈研究。
对卫生部门和专业的 13 名医疗保健专业人员进行了半结构化的个人访谈。定性分析的策略受到 Kirsti Malterud 的启发,并被标记为“系统文本压缩”。这种策略是一种对定性数据进行跨案例主题分析的描述性和探索性方法。
从分析中出现了四个主题/类别;“组织因素”、“护理方法”、“沟通和知识”和“关系”。
不同的组织文化可能会阻碍跨部门的护理协调。护理方法在卫生部门和专业之间的各个层面都有所不同。组织、领导和专业身份会影响工作文化,在未来招聘和医护人员社会化时必须加以考虑。我们的研究表明,需要结合医疗保健标准化和灵活、适应性的解决方案来改善跨部门的护理协调。