Loveday Sarah, White Natalie, Constable Leanne, Gates Anthony, Sanci Lena, Goldfeld Sharon, Hiscock Harriet
Department of Paediatrics, University of Melbourne, Australia.
Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Int J Integr Care. 2024 Nov 15;24(4):9. doi: 10.5334/ijic.8631. eCollection 2024 Oct-Dec.
Childhood adversity is associated with poor physical and mental health outcomes across the lifespan. Integration of health and social care may provide a solution to childhood adversity through practices of better detection and response. There is growing interest in the creation of child and family hubs that integrate health and social care but little literature that describes the development process.
We aimed to evaluate and describe the implementation of a co-designed health and social care child and family hub in Victoria, Australia. Rapid ethnographic methodology was used to iterate the hub components. Practitioners and researchers co-created solutions to barriers identified during implementation.
There were five key learnings: (i) Practice change takes time and intensive coaching, (ii) Lived experience is a powerful motivator for practice change, (iii) Integration of services requires more than co-location to break down silos, (iv) Reflective practice is a key driver of practice change, and (v) Using real time data enabled rapid implementation change and directly informed the development of solutions.
Maintaining and developing practice change during implementation requires time and access to a broad range of data to enable iteration and the development of solutions.
童年逆境与一生中心理和身体健康不佳有关。整合医疗与社会护理可能通过更好的检测和应对措施为童年逆境提供解决方案。人们对创建整合医疗与社会护理的儿童和家庭中心的兴趣日益浓厚,但描述其发展过程的文献却很少。
我们旨在评估并描述澳大利亚维多利亚州一个共同设计的儿童和家庭健康与社会护理中心的实施情况。采用快速人种志方法对中心组成部分进行反复优化。从业者和研究人员共同针对实施过程中发现的障碍提出解决方案。
有五点关键经验教训:(i)实践变革需要时间和深入指导;(ii)亲身经历是实践变革的强大动力;(iii)服务整合不仅需要同地办公以打破壁垒;(iv)反思性实践是实践变革的关键驱动力;(v)使用实时数据能够实现快速的实施变革,并直接为解决方案的制定提供依据。
在实施过程中维持和发展实践变革需要时间,并获取广泛的数据,以实现反复优化和解决方案的制定。