Möckli Nathalie, Espinosa J Alberto, Simon Michael, Meyer-Massetti Carla, Zúñiga Franziska
Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, CH-4056 Basel, Switzerland.
Kogod School of Business, American University, 4400 Massachusetts Avenue, Washington, DC, NW, 20016, USA.
Heliyon. 2023 Mar 3;9(3):e14243. doi: 10.1016/j.heliyon.2023.e14243. eCollection 2023 Mar.
Effective healthcare coordination is vital when such care is provided as a collaborative effort by many individuals and their task activities are interdependent. Coordination is necessary to ensure that care not only meets the needs of patients, but also avoids negative consequences for them due to omitted, inefficient, unnecessary, or even incorrect treatments. It also helps conserve resources. This has contributed to a rapid increase in articles on this subject. Still, while care coordination topics are gaining the attention of researchers, there are a number of issues experienced, including the delineation of limitations, inconsistent definitions, and problems with measurement. Therefore, the aim of this article is to refine the concept of homecare coordination and provide a comprehensive theoretical framework, illustrated with examples from practice. Focusing on this goal, we have reviewed the extant literature on the subject to develop a theoretical homecare coordination framework. The first intermediary goal was to integrate relevant concepts across multiple theories and frameworks into a unified synthesis. We do so in two parts: (1) analysis of extant coordination frameworks and theories; and (2) the presentation of our newly developed theoretical framework for homecare coordination. The new framework differentiates clearly between coordination as a process-i.e., what people do to coordinate and coordination as an outcome-i.e., the state of coordination. Applying this distinction to both, measurement and interpretation of results helps avoid misleading conclusions. As a research outcome, our framework builds upon the extant coordination literature, considers the complex relationships among the various coordination-related factors and, while focusing on homecare, is applicable to various healthcare settings in general. A nuanced differentiation and explanation of the elements involved enable a more consistent operationalization of the coordination concept. Additionally, as they explicitly address the healthcare system's micro, meso, and macro levels, they can be applied across diverse healthcare settings to investigate homecare coordination.
当医疗保健作为许多人共同协作的努力来提供，且他们的任务活动相互依存时，有效的医疗协调至关重要。协调是必要的，以确保医疗不仅满足患者的需求，还能避免因治疗遗漏、低效、不必要甚至错误而给患者带来负面后果。它还有助于节约资源。这导致了关于该主题的文章迅速增加。尽管如此，虽然护理协调主题正受到研究人员的关注，但仍存在一些问题，包括局限性的界定、定义不一致以及测量问题。因此，本文的目的是完善家庭护理协调的概念，并提供一个全面的理论框架，同时辅以实践中的例子进行说明。围绕这一目标，我们回顾了关于该主题的现有文献，以构建一个家庭护理协调的理论框架。第一个中间目标是将多个理论和框架中的相关概念整合为一个统一的综合体。我们分两部分进行：（1）对现有协调框架和理论的分析；（2）展示我们新开发的家庭护理协调理论框架。新框架明确区分了作为过程的协调（即人们为进行协调所做的事情）和作为结果的协调（即协调状态）。将这种区分应用于结果的测量和解释，有助于避免得出误导性结论。作为一项研究成果，我们的框架建立在现有协调文献的基础上，考虑了各种与协调相关因素之间的复杂关系，并且在关注家庭护理的同时，总体上适用于各种医疗环境。对所涉及要素进行细致入微的区分和解释，能够使协调概念的操作更加一致。此外，由于它们明确涉及医疗系统的微观、中观和宏观层面，因此可以应用于不同的医疗环境来研究家庭护理协调。
