Lennips A J, Peters V J T, Meijboom B R, Nissen A C, Bunt J E H
Department of Health Services Management & Organization, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Department of Information Systems and Operations Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, the Netherlands.
Eur J Pediatr. 2024 May;183(5):2463-2476. doi: 10.1007/s00431-024-05497-4. Epub 2024 Mar 12.
Care provision for children with anorexia nervosa is provided by outpatient care teams in hospitals, but the way these teams are organized differs per hospital and hampers the continuity of care. The aim of this study is to explore the organization and continuity of care for children with anorexia nervosa in the Netherlands by using a modular perspective.We conducted a qualitative, exploratory case study and took the healthcare provision for children with anorexia nervosa, provided by outpatient care teams, as our case. We conducted nine interviews with healthcare professionals involved in outpatient care teams from six hospitals. A thematic analysis was used to analyze the data.The modular perspective offered insights into the work practices and working methods of outpatient care teams. We were able to identify modules (i.e. the separate consultations with the various professionals), and components (i.e. elements of these consultations). In addition, communication mechanisms (interfaces) were identified to facilitate information flow and coordination among healthcare professionals. Our modular perspective revealed gaps and overlap in outpatient care provision, consequently providing opportunities to deal with unnecessary duplications and blind spots. Conclusion: A modular perspective can be applied to explore the organization of outpatient care provision for children with anorexia nervosa. We specifically highlight gaps and overlap in healthcare provision, which in turn leads to recommendations on how to support the three essential parts of continuity of care: informational continuity, relational continuity, and management continuity. What is Known: • Care provision for children with anorexia nervosa requires a network of health care professionals from different organizations, as a result the organization and provision of care faces challenges. What is New: • Modular care provision sheds light on the complexity and organization of outpatient care provision and supports the three dimensions of continuity of care as experienced by children with anorexia nervosa and their parents/caregivers.
医院的门诊护理团队为神经性厌食症患儿提供护理服务，但各医院这些团队的组织方式有所不同，这妨碍了护理的连续性。本研究的目的是从模块化视角探索荷兰神经性厌食症患儿护理的组织情况及连续性。我们开展了一项定性探索性案例研究，将门诊护理团队为神经性厌食症患儿提供的医疗服务作为案例。我们对来自六家医院门诊护理团队的医疗专业人员进行了九次访谈。采用主题分析法对数据进行分析。模块化视角为门诊护理团队的工作实践和工作方法提供了见解。我们能够识别模块（即与不同专业人员的单独会诊）和组件（即这些会诊的要素）。此外，还确定了沟通机制（接口），以促进医疗专业人员之间的信息流和协调。我们的模块化视角揭示了门诊护理服务中的差距和重叠，从而提供了处理不必要重复和盲点的机会。结论：模块化视角可用于探索神经性厌食症患儿门诊护理服务的组织情况。我们特别强调了医疗服务中的差距和重叠，进而就如何支持护理连续性的三个关键部分提出建议：信息连续性、关系连续性和管理连续性。已知信息：• 神经性厌食症患儿的护理需要不同组织的医疗专业人员网络，因此护理的组织和提供面临挑战。新发现：• 模块化护理服务揭示了门诊护理服务的复杂性和组织情况，并支持神经性厌食症患儿及其父母/照顾者所体验的护理连续性的三个维度。
