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1

Kovačić, Matija, Vesna Sesar y Sanja Zlatić. "INTEGRATED MANAGEMENT SYSTEMS IN HEALTH CARE". QUALITY – YESTERDAY, TODAY, TOMORROW 21, n.º 1 (marzo de 2020): 451–61. http://dx.doi.org/10.30657/hdmk.2020.28.

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Rao, Ranga. "Integrated care systems: can they deliver?" BJPsych Advances 29, n.º 1 (19 de diciembre de 2022): 41–43. http://dx.doi.org/10.1192/bja.2022.78.

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SUMMARYThis commentary is a response to three articles on integrated care systems in this journal. It explores some aspects of the latest transformation of England's National Health Service (NHS) and raises some questions on the extent to which the proposed NHS Long Term Plan can deliver on the current challenges.
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3

Alexander, Jeffrey A., Howard S. Zuckerman y Dennis D. Pointer. "The challenges of governing integrated health care systems". Health Care Management Review 20, n.º 4 (1995): 69–81. http://dx.doi.org/10.1097/00004010-199502040-00012.

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4

Alexander, Jeffrey A., Howard S. Zuckerman y Dennis D. Pointer. "The challenges of governing integrated health care systems". Health Care Management Review 20, n.º 4 (1995): 69–81. http://dx.doi.org/10.1097/00004010-199523000-00012.

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5

Peterson Sinclair, Barbara. "Advanced Practice Nurses in Integrated Health Care Systems". Journal of Obstetric, Gynecologic & Neonatal Nursing 26, n.º 2 (marzo de 1997): 217–23. http://dx.doi.org/10.1111/j.1552-6909.1997.tb02136.x.

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6

Morris, Arden M. "Putting the Integration Into Integrated Health Care Systems". Journal of Clinical Oncology 33, n.º 8 (10 de marzo de 2015): 821–22. http://dx.doi.org/10.1200/jco.2014.59.6015.

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7

Plochg, Thomas, Stefania Ilinca y Mirko Noordegraaf. "Beyond integrated care". Journal of Health Services Research & Policy 22, n.º 3 (5 de abril de 2017): 195–97. http://dx.doi.org/10.1177/1355819617697998.

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Integrated care tops the health care agenda. But more integration alone will not remedy the crisis in health care, and there is a danger in the increasingly prevalent conceptualization of care integration as a goal in itself rather than as an instrument for improving performance. Operating integrated care systems, staffed by an overly specialized medical workforce, is unsustainable in terms of human and financial resources and is likely to produce little benefit for patients with multi-morbidity. An alternative approach involves health care leaders going beyond integrated care and nurturing transformative change from within the medical workforce instead. To be fit for purpose, the doctors must be encouraged and facilitated to customize their expertise to current and expected future burdens of disease. This would lead to more adaptive doctors who could actively support people in healing and managing their own health. Integrated care should be conceptualized as one possible lever for transformative change rather than its endpoint.
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8

Engelmann, U. y H.-P. Meinzer. "Medical Images in Integrated Health Care Workstations". Yearbook of Medical Informatics 05, n.º 01 (agosto de 1996): 87–94. http://dx.doi.org/10.1055/s-0038-1638049.

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AbstractThe difference between an invention and a discovery is discussed, before turning to the sources of medical images. Next, the ongoing integration of image modalities in clinical routine is reviewed, as well as improvements in diagnosis and therapy planning with the help of better images in inter-connected distributed systems. Current shortcomings of image processing, and the attempts to overcome these shortcomings are presented. Examples of image processing are given, together with a vision on future systems and procedures.
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9

De Kuiper, Marlou, Ferdy Pluck y Anneke De Jong. "Systems Theory for Integrated Care Design". International Journal of Integrated Care 22, S3 (4 de noviembre de 2022): 132. http://dx.doi.org/10.5334/ijic.icic22405.

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DAWSON, WENDY, STEPHANIE BROWN, JANE GUNN, RUTH MCNAIR y JUDITH LUMLEY. "Sharing obstetric care: barriers to integrated systems of care". Australian and New Zealand Journal of Public Health 24, n.º 4 (agosto de 2000): 401–6. http://dx.doi.org/10.1111/j.1467-842x.2000.tb01602.x.

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11

Funkat, G., A. Haeber, C. Mauz-Koerholz, K. Pommerening, S. Smers, J. Stausberg y A. Winter. "Integrated Information Systems for Translational Medicine". Methods of Information in Medicine 46, n.º 05 (2007): 601–7. http://dx.doi.org/10.1160/me9063.

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Summary Objectives: Translational medicine research needs a two-way information highway between ‘bedside’ and ‘bench’. Unfortunately there are still weak links between successfully integrated information roads for bench, i.e. research networks, and bedside, i.e. regional or national health information systems. The question arises, what measures have to be taken to overcome the deficiencies. Methods: It is examined how patient care-related costs of clinical research can be separated and shared by health insurances, whether quality of patient care data is sufficient for research, how patient identity can be maintained without conflict to privacy, how care and research records can be archived, and how information systems for care and research can be integrated. Results: Since clinical trials improve quality of care, insurers share parts of the costs. Quality of care data has to be improved by introducing minimum basic data sets. Pseudonymization solves the conflict between needs for patient identity and privacy. Archiving patient care records and research records is similar and XML and CDISC can be used. Principles of networking infrastructures for care and research still differ. They have to be bridged first and harmonized later. Conclusions: To link information systems for care (bed) and for research (bench) needs technical infrastructures as well as economic and organizational regulations.
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12

Tsiachristas, Apostolos, Rafael Perera y Ray Fitzpatrick. "A rationing framework for Integrated Care Systems." International Journal of Integrated Care 23, S1 (28 de diciembre de 2023): 454. http://dx.doi.org/10.5334/ijic.icic23166.

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Background: Over the last 20 years, the NHS has introduced multiple changes in the commissioning structures, aiming at promoting integrated care in England. The Health and Care Bill 2021 is the latest and farthest-reaching reform, under which local commissioners from the emerging Integrated Care System (ICSs) are expected to accelerate the implementation of ‘integrated care programmes’. This overhaul demands local commissioners to develop approaches to robustly monitor and assess ‘integrated care programmes’ when making investment decisions. This research project aims to develop a framework to support the local commissioning of integrated care in England. Methods: To understand the decision-context and identify the most relevant monitoring and assessment criteria, we conducted 26 semi-structured interviews with local stakeholders. To supplement the criteria and inform the development of the evaluation component, we conducted a systematic literature review on the use of multi-criteria decision analysis (MCDA) in healthcare. The monitoring component of the framework is based on key performance indicators. A system-adjusted time-trend is used to identify ‘integrated care programmes’ that underperform and consequently should be re-assessed. For the evaluation component, we develop a value-measurement MCDA. To define the relative importance of the assessment criteria on the basis of public values, we conducted a discrete choice experiment (DCE) with members from the public in England. In the DCE, participants are presented with two hypothetical care programmes, described by six attributes (assessment criteria), and are asked to state their choice. The design of this experiment was informed by the literature, local stakeholders, and representatives from the Oxford & Thames Valley Patient and Public Involvement group. Standardised performance scores will be estimated using routinely collected data and quasi-experimental methods. Preliminary results: The emerging ICSs open an opportunity for local decision-makers to strengthen the commissioning process, and the proposed framework can potentially contribute to this end. In the interviews, stakeholders indicated that health outcomes, quality of care, cost and equity should be the main drivers of investment decisions. Similar criteria were used in 55 MCDA studies developed to guide priority-setting decisions in high-income countries, with most of these studies using the value-measurement approach. Intermediate health outcomes, compliance with national guidelines, quality of care and equity in access are defined as the monitoring criteria. The assessment criteria are six: final health outcomes, health-related quality of life, patient experience, size of the target population, equity and cost. According to the DCE conducted with 440 members from the public, the six attributes are statistically significant. Next steps: The structure of the framework has been presented to local stakeholders. Based on the data available and how ICSs are starting to operate, it seems that the framework could be applied to support the local commissioning of integrated care. We will demonstrate the framework’s applicability with an evaluation of integrated mental health services in Oxfordshire. We also aim to incorporate social care into the framework and, with this, identify potential data gaps. Afterwards, we will develop a user-friendly software to facilitate the use of the framework by other ICSs across England.
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13

Dymyt, Małgorzata. "DESIGNING AN INTEGRATED HEALTH CARE STRATEGY". Zeszyty Naukowe Wyższej Szkoły Humanitas Zarządzanie 21, n.º 1 (31 de marzo de 2020): 65–76. http://dx.doi.org/10.5604/01.3001.0014.1236.

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The article concerns the strategic dimension of the integration of health care. The concept of integrated health care plays a key role in the improvement of health systems. The complexity of the health care system makes a coherent, comprehensive and coordinated approach to health services necessary. The integration of health care consists in the management and delivery of health services in such a way that patients receive continuity of health care, coordinated at various levels, within and outside the health sector and as needed throughout their lives. The purpose of the article is to present the essence of health care integration and key aspects of the design of integrated healthcare strategy, identify its assumptions and main elements.
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14

Duncan, Monica. "Integrated care systems and nurse leadership". British Journal of Community Nursing 24, n.º 11 (2 de noviembre de 2019): 538–42. http://dx.doi.org/10.12968/bjcn.2019.24.11.538.

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There will be significant changes to the way in which primary and community health services are provided in the wake of the NHS Long Term Plan published in January 2019. Community nurses are already preparing themselves for these changes by exploring models of care that are patient-centred and link to neighbourhood, place and system levels. This article discusses two examples of such models of care, the Buurtzorg and Embrace model, both from the Netherlands. Styles of leadership and associated development, both within nursing and on a multi-professional basis will be crucial to ensure success. This article outlines Alban-Metcalfe's engaging transformational leadership model as a potential platform to move to flatter, more diverse teams and collective leadership.
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15

Choi, Lisa C. "Tax-Exempt Status and Integrated Delivery Systems". Journal of Law, Medicine & Ethics 23, n.º 4 (1995): 403–6. http://dx.doi.org/10.1111/j.1748-720x.1995.tb01387.x.

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Within the health care industry, the move from regulatory cost controls to market competition has generated rapid and dramatic restructuring of providers. To enhance their competitive positions in the evolving market, many health care organizations are pursuing the ownership and integration of all elements and stages of health care delivery and payment, with the goal of increasing access to capital and lowering costs through administrative efficiencies and economies of scale. As of July 1994, 24 percent of hospitals were members of an integrated delivery system (IDS), and 47 percent were involved in IDS development.IDSs pose a singular challenge to the Internal Revenue Service (IRS). The IRS recognizes that its traditional policies for granting tax exempt status are not flexible enough for the competitive and rapidly changing health care market. In recent years, the IRS has taken a more active role in scrutinizing emerging health care institutions seeking taxexempt status.
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16

Leatt, Peggy y Sandra G. Leggatt. "Governing Integrated Health Delivery Systems: Meeting Accountability Requirements". Healthcare Management Forum 10, n.º 4 (diciembre de 1997): 12–18. http://dx.doi.org/10.1016/s0840-4704(10)60976-3.

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Many Canadian provincial governments are exploring methods to increase the integration of health services in an effort to improve the care provided, while maintaining or reducing the costs. Integrated health delivery systems are being implemented in the United States, Britain and other European countries. Such systems aim to provide a full continuum of care to a defined target population under a financing system of capitation. This article explores the issues associated with the governance accountabilities of an IDS. A review of potential governance models is completed, and the factors that influence the choice of a governance model for an integrated delivery system are presented. In 1987, Ewell identified governing boards as the weakest link in the integrated health care systems of the United States. It is suggested that early attention to governance in the development of IDS models in Canada may improve the effectiveness of these systems.
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17

Goddard, Maria. "Integrated care systems and equity: prospects and plans". Journal of Integrated Care 31, n.º 5 (13 de febrero de 2023): 29–42. http://dx.doi.org/10.1108/jica-08-2022-0044.

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PurposePolicies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.Design/methodology/approachThe analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.FindingsThe place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.Originality/valueThis study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.
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18

Levin, T. R., L. Jamieson, D. A. Burley, J. Reyes, M. Oehrli y C. Caldwell. "Organized Colorectal Cancer Screening in Integrated Health Care Systems". Epidemiologic Reviews 33, n.º 1 (27 de junio de 2011): 101–10. http://dx.doi.org/10.1093/epirev/mxr007.

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19

Connelly, Donald P. "Integrating Integrated Laboratory Information into Health Care Delivery Systems". Clinics in Laboratory Medicine 19, n.º 2 (junio de 1999): 277–98. http://dx.doi.org/10.1016/s0272-2712(18)30115-x.

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20

Tham, Tat Yean, Thuy Linh Tran, Somjit Prueksaritanond, Josefina Isidro, Sajita Setia y Vicknesh Welluppillai. "Integrated health care systems in Asia: an urgent necessity". Clinical Interventions in Aging Volume 13 (diciembre de 2018): 2527–38. http://dx.doi.org/10.2147/cia.s185048.

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21

Zellmer, William A. "Opportunity for pharmacy leadership in integrated health care systems". American Journal of Health-System Pharmacy 53, suppl_1 (1 de febrero de 1996): S3—S4. http://dx.doi.org/10.1093/ajhp/53.4_suppl_1.s3.

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Sahney, Vinod K. "Integrated health care systems: Current status and future outlook". American Journal of Health-System Pharmacy 53, suppl_1 (1 de febrero de 1996): S4—S7. http://dx.doi.org/10.1093/ajhp/53.4_suppl_1.s4.

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23

Best, Stephanie y Sharon Williams. "Integrated care: mobilising professional identity". Journal of Health Organization and Management 32, n.º 5 (20 de agosto de 2018): 726–40. http://dx.doi.org/10.1108/jhom-01-2018-0008.

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Purpose Integrated care has been identified as essential to delivering the reforms required in health and social care across the UK and other healthcare systems. Given this suggests new ways of working for health and social care professionals, little research has considered how different professions manage and mobilise their professional identity (PI) whilst working in an integrated team. The paper aims to discuss these issues. Design/methodology/approach A qualitative cross-sectional study was designed using eight focus groups with community-based health and social care practitioners from across Wales in the UK during 2017. Findings Participants reported key factors influencing practice were communication, goal congruence and training. The key characteristics of PI for that enabled integrated working were open mindedness, professional trust, scope of practice and uniqueness. Blurring of boundaries was found to enable and hinder integrated working. Research limitations/implications This research was conducted in the UK which limits the geographic coverage of the study. Nevertheless, the insight provided on PI and integrated teams is relevant to other healthcare systems. Practical implications This study codifies for health and social care practitioners the enabling and inhibiting factors that influence PI when working in integrated teams. Originality/value Recommendations in terms of how healthcare professionals manage and mobilise their PI when working in integrated teams are somewhat scarce. This paper identifies the key factors that influence PI which could impact the performance of integrated teams and ultimately, patient care.
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24

Araujo de Carvalho, Islene. "Person-centered and Integrated Care for Ageing Populations". International Journal of Person Centered Medicine 5, n.º 2 (9 de noviembre de 2015): 64–67. http://dx.doi.org/10.5750/ijpcm.v5i2.525.

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Background: Disintegrated and uncoordinated services and those neglecting the concerns of users tend to be associated to negative health outcomes for older people. Objectives: This paper is aimed at exploring how the concept of person centred care can be relevant for ageing populations and its implications for health systems.Methods: These involved a critical review of the literature, both standard scientific data banks as well as internet-based sources. Results: It was found that the best way to reorient health systems towards the goal of healthy ageing is by placing older people at the centre of service delivery. While people-centered and integrated services are fundamental for all including ageing people, the strategy mix may be optimized by attending to the goals of healthy ageing and the older person’s values. Discussion and Conclusions: An older person-centred integrated health care delivery model that focuses on prevention and care coordination seems to be the best approach to reorienting health systems. Successful older-people-centred health services are organized around the needs of older people, acknowledging their intrinsic value and contribution to society, and enabling their functional abilities.
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25

Sakoh, Masaharu. "Health Care-Medical-Welfare City Plan and Community-based Integrated Care Systems". Japanese Journal of Rehabilitation Medicine 55, n.º 2 (2018): 137–42. http://dx.doi.org/10.2490/jjrmc.55.137.

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Lewis, Melissa E. y Laurelle L. Myhra. "Integrated Care with Indigenous Populations: Considering the Role of Health Care Systems in Health Disparities". Journal of Health Care for the Poor and Underserved 29, n.º 3 (2018): 1083–107. http://dx.doi.org/10.1353/hpu.2018.0081.

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27

Hall, Kris, Amy Zimmerman, Janet Samos, Peter R. Simon y William H. Hollinshead. "Coordinating Care for Children’s Health: A Public Health Integrated Information Systems Approach". American Journal of Preventive Medicine 13, n.º 2 (marzo de 1997): 32–36. http://dx.doi.org/10.1016/s0749-3797(18)30110-7.

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Martínez, Jordi, Donna Henderson, Tino Martí y Joan Carles Contel. "Benchmarking Integrated Health and Social Care Information Systems in Europe". International Journal of Integrated Care 16, n.º 6 (16 de diciembre de 2016): 237. http://dx.doi.org/10.5334/ijic.2785.

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Crosson, Francis J. "21st-Century Health Care — The Case for Integrated Delivery Systems". New England Journal of Medicine 361, n.º 14 (octubre de 2009): 1324–25. http://dx.doi.org/10.1056/nejmp0906917.

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30

Johnson, Richard L. "Commentary on ”The challenges of governing integrated health care systems". Health Care Management Review 20, n.º 4 (1995): 82–87. http://dx.doi.org/10.1097/00004010-199502040-00013.

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31

McCool, Barbara P. "Commentary on ”The challenges of governing integrated health care systems". Health Care Management Review 20, n.º 4 (1995): 88–90. http://dx.doi.org/10.1097/00004010-199502040-00014.

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32

Toomey, Robert E. "Commentary on ”The challenges of governing integrated health care systems". Health Care Management Review 20, n.º 4 (1995): 91–92. http://dx.doi.org/10.1097/00004010-199502040-00015.

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33

Johnson, Richard L. "Commentary on “The challenges of governing integrated health care systems”". Health Care Management Review 20, n.º 4 (1995): 82–87. http://dx.doi.org/10.1097/00004010-199523000-00013.

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34

McCool, Barbara P. "Commentary on “The challenges of governing integrated health care systems”". Health Care Management Review 20, n.º 4 (1995): 88–90. http://dx.doi.org/10.1097/00004010-199523000-00014.

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35

Toomey, Robert E. "Commentary on “The challenges of governing integrated health care systems”". Health Care Management Review 20, n.º 4 (1995): 91–92. http://dx.doi.org/10.1097/00004010-199523000-00015.

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36

Ritzwoller, D. P. "Creating Standard Cost Measures Across Integrated Health Care Delivery Systems". Journal of the National Cancer Institute Monographs 2005, n.º 35 (1 de noviembre de 2005): 80–87. http://dx.doi.org/10.1093/jncimonographs/lgi043.

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Coward, P. M. "From Nursing Information Systems to Patient Information Systems". Methods of Information in Medicine 33, n.º 03 (1994): 302–3. http://dx.doi.org/10.1055/s-0038-1635021.

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Abstract:Clinical information systems, developed for specific disciplines, reinforce the fragmentation of patient care and fail to support integrated, patient centered approaches. Fundamental restructuring of systems development is required to prepare the health care system and the practice of nursing for the future.
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De Kuiper, Marlou. "The Neuman Systems Model for Integrated Care Design". International Journal of Integrated Care 21, S1 (1 de septiembre de 2021): 280. http://dx.doi.org/10.5334/ijic.icic20161.

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Hildebrandt, Helmut y Timo Schulte. "Reducing Hospitalisations for Ambulatory Care-sensitive Conditions in Integrated Care Systems". International Journal of Integrated Care 17, n.º 5 (17 de octubre de 2017): 314. http://dx.doi.org/10.5334/ijic.3631.

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Susič, Antonija Poplas y Zalika Klemenc-Ketiš. "Successful implementation of integrated care in Slovenian primary care". Slovenian Journal of Public Health 60, n.º 1 (31 de diciembre de 2020): 1–3. http://dx.doi.org/10.2478/sjph-2021-0001.

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Abstract For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.
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Leggat, Sandra G. y Peggy Leatt. "A Framework for Assessing the Performance of Integrated Health Delivery Systems". Healthcare Management Forum 10, n.º 1 (abril de 1997): 11–18. http://dx.doi.org/10.1016/s0840-4704(10)61148-9.

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Competing demands for resources within the health care system require health care providers to ensure the most effective and efficient use of resources. The evidence from the United States, the United Kingdom and other jurisdictions suggests that integrated health delivery systems (IDS) may be a cost-effective way to meet the health care needs of a population. This article introduces a framework for use in monitoring and evaluating the performance of an integrated delivery system. The establishment of a consistently used evaluation framework for integrated delivery systems will provide the government, governing bodies and other evaluators with an effective assessment tool that will enable greater understanding of the impact of the IDS on the health care system. It will also provide information to enable ongoing performance improvements within the system.
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42

Harvey, Andrew. "Integrated person-centred systems of care for complex needs - Moving forward towards person-centred integrated care". International Journal of Integrated Care 22, S1 (8 de abril de 2022): 77. http://dx.doi.org/10.5334/ijic.icic21046.

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Harris, Ruth, Simon Fletcher, Sarah Sims, Fiona Ross, Sally Brearley y Jill Manthorpe. "Developing programme theories of leadership for integrated health and social care teams and systems: a realist synthesis". Health and Social Care Delivery Research 10, n.º 7 (marzo de 2022): 1–118. http://dx.doi.org/10.3310/wpng1013.

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Background As the organisation of health and social care in England moves rapidly towards greater integration, the resulting systems and teams will require distinctive leadership. However, little is known about how the effective leadership of these teams and systems can be supported and improved. In particular, there is relatively little understanding of how effective leadership across integrated care teams and systems may be enacted, the contexts in which this might take place and the subsequent implications this has on integrated care. Objective This realist review developed and refined programme theories of leadership of integrated health and social care teams and systems, exploring what works, for whom and in what circumstances. Design The review utilised a realist synthesis approach, informed by the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards, to explore existing literature on the leadership of integrated care teams and systems, complemented by ongoing stakeholder consultation. Empirical evidence specifically addressing leadership of integrated teams or services was limited, with only 36 papers included in the review. The evidence collected from these 36 papers was synthesised to identify and build a comprehensive description of the mechanisms of leadership of integrated teams and systems and their associated contexts and outcomes. Consultation with key stakeholders with a range of expertise throughout the process ensured that the review remained grounded in the reality of health and social care delivery and addressed practice and policy challenges. Results Evidence was identified for seven potentially important components of leadership in integrated care teams and systems. These were ‘inspiring intent to work together’, ‘creating the conditions to work together’, ‘balancing multiple perspectives’, ‘working with power’, ‘taking a wider view’, ‘a commitment to learning and development’ and ‘clarifying complexity’. No empirical evidence was found for an eighth mechanism, ‘fostering resilience’, although stakeholders felt that this was potentially an important, long-term component of leadership. A key message of the review was that empirical research often focused on the importance of who the leader of an integrated team or service was (i.e. their personality traits and characteristics) rather than what they did (i.e. the specific role that they played in integrated working), although stakeholders considered that a focus on leader personality was not sufficient. Other key messages highlighted the way in which power and influence are used by integrated service leaders and identified the hierarchies between health and social care which complicate the leading of integrated teams and systems. Limitations Evidence specifically addressing leadership of integrated care teams and systems was limited and lacking in detail, which restricted the degree to which definitive conclusions could be drawn around what works, for whom and in what circumstances. Conclusions Research into the leadership of integrated care teams and systems is limited and underdeveloped, with ideas often reverting to existing framings of leadership in which teams and organisations are less complex. In making explicit some of the assumptions about how leaders lead integrated care teams and systems this review has contributed significant new perspectives, offering fresh theoretical grounding that can be built on, developed and tested further. Future work By making explicit some of the assumptions underlying the leadership of integrated care teams and systems, this review has generated new perspectives that can be built on, developed and tested further. Study registration This study is registered as PROSPERO CRD42018119291. Funding This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 7. See the NIHR Journals Library website for further project information.
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Goniewicz, Krzysztof, Eric Carlström, Attila J. Hertelendy, Frederick M. Burkle, Mariusz Goniewicz, Dorota Lasota, John G. Richmond y Amir Khorram-Manesh. "Integrated Healthcare and the Dilemma of Public Health Emergencies". Sustainability 13, n.º 8 (19 de abril de 2021): 4517. http://dx.doi.org/10.3390/su13084517.

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Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering from numerous comorbidities and diseases, being recruited for care, there is a need for a change in the healthcare service structure beyond direct-patient care to be compatible in peacetime and during public health emergencies. This article’s objective is to discuss the opportunities and obstacles for increasing the effectiveness of healthcare through improved integration. A rapid evidence review approach was used by performing a systematic followed by a non-systematic literature review and content analysis. The results confirmed that integrated healthcare systems play an increasingly important role in healthcare system reforms undertaken in European Union countries. The essence of these changes is the transition from the episodic treatment of acute diseases to the provision of coordinated medical services, focused on chronic cases, prevention, and ensuring patient continuity. However, integrated healthcare, at a level not yet fully defined, will be necessary if we are to both define and attain the integrated practice of both global health and global public health emergencies. This paper attains the necessary global challenges to integrate healthcare effectively at every level of society. There is a need for more knowledge to effectively develop, support, and disseminate initiatives related to coordinated healthcare in the individual healthcare systems.
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45

Weisgrau, Sheldon, Luisa Buada, Martha Campbell y Ira Moscovice. "Rural Integrated Systems In California: Preparing For Managed Care". Health Affairs 18, n.º 5 (septiembre de 1999): 237–41. http://dx.doi.org/10.1377/hlthaff.18.5.237.

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Emmesjö, Lina, Jenny Hallgren, Anna Dahl Aslan y Catharina Gillsjö (Gillsjo). "A MOBILE HOME HEALTH CARE PHYSICIAN FOR OLDER PERSONS WITH EXTENSIVE HEALTH CARE NEEDS". Innovation in Aging 7, Supplement_1 (1 de diciembre de 2023): 694. http://dx.doi.org/10.1093/geroni/igad104.2253.

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Abstract Background The rapidly increasing older population with extensive care needs has shifted health care from institutions to the older person’s home. A cross-organisational integrated care model was created by health care authorities to meet these challenges, the Mobile integrated care model. The Mobile integrated care model with a home health care physician is a collaboration between regional and municipal health care, working in the patients’ home. Methods Semi-structured interviews with patients, next of kin and health care professionals. Results The home was described by all as the best place to provide health care to these patients, creating safety and increasing autonomy for the patients. The health care professionals found trust in working together as a team, but struggled because of the divided organizations. Patients and next of kin found the Mobile integrated care model to be hierarchic, where the structure sometimes improved participation, and at other times prevented it. Conclusion All participant groups emphasized that there was a need for more time for the health care personnel to spend with the patients. Furthermore, the patients and next of kin longed for a personal contact and being able to form a relationship with the health care personnel. The health care professionals found being employed by separate organizations as a challenge, where divided documentation systems and lack of equipment hindered the work.
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47

Chubak, Jessica, Leah Tuzzio, Clarissa Hsu, Catherine M. Alfano, Borsika A. Rabin, Mark C. Hornbrook, Adele Spegman, Ann Von Worley, Andrew Williams y Larissa Nekhlyudov. "Providing Care for Cancer Survivors in Integrated Health Care Delivery Systems: Practices, Challenges, and Research Opportunities". Journal of Oncology Practice 8, n.º 3 (mayo de 2012): 184–89. http://dx.doi.org/10.1200/jop.2011.000312.

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Kennedy, Teri. "STRENGTH IN AGE-FRIENDLY HEALTH SYSTEMS: AN INNOVATIVE INTEGRATED INTERPROFESSIONAL MODEL". Innovation in Aging 3, Supplement_1 (noviembre de 2019): S829. http://dx.doi.org/10.1093/geroni/igz038.3054.

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Abstract This paper presents an innovative conceptual approach to health care policy for older adults: the Age-Friendly Health Systems Integrated Interprofessional Model. In 2017, the John A. Hartford Foundation and Institute for Healthcare Improvement, in partnership with the American Hospital Association and Catholic Health Association of the United States, advanced the concept of an Age-Friendly Health System. This initiative is designed to respond to the needs of a burgeoning U.S. older adult population, expected to double from 2012 to 2050, largely due to the aging of Baby Boomers and increased life expectancy. These Baby Boomers will demand a well-coordinated, communicative health system responsive to their values and preferences. In an Age-Friendly Health System, all older adults receive the best possible care, without care-related harms, and with satisfaction of care received. Essential elements include what matters, mentation, mobility, and medications, with a focus on patient-directed, family-engaged care. While a solid framework for improving healthcare for older adults, this model is further strengthened by incorporating the essential elements of person-, family-, and community-centered approaches to care; interprofessional team-based competencies, and Quadruple Aim outcomes. This enhanced model, referred to as the Age-Friendly Health System Integrated Interprofessional Model, combines elements essential to quality healthcare within the framework of an Age-Friendly Health System. This paper will present the original Age-Friendly Health System framework, the proposed Age-Friendly Health System Integrated Interprofessional Model, then compare and contrast each model’s essential principles. Implications for adoption of this enhanced model for policy, education, and practice will be explored.
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49

Evashwick, Connie, Allen Meadors y Robert Friis. "The Role of Home Care in Integrated Delivery Systems". Home Health Care Services Quarterly 17, n.º 3 (marzo de 1999): 49–69. http://dx.doi.org/10.1300/j027v17n03_04.

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Chu, Kevin Wing Ki y Lenis Lai Wan Cheung. "Incorporating sustainability in small health-care facilities: an integrated model". Leadership in Health Services 31, n.º 4 (1 de octubre de 2018): 441–51. http://dx.doi.org/10.1108/lhs-07-2017-0043.

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PurposeIt is challenging for small health-care facilities to implement changes when human and financial resources are limited for day-to-day operations. This paper aims to propose an integrated model for small- and medium-sized health-care facilities to integrate sustainability in their day-to-day operations, which have been derived from the leadership and change theories.Design/methodology/approachDrawing on previous research on leadership and change theories, the paper first critically reviewed the approaches to implementing changes and how applicable they are in the context of small- and medium-sized health-care facilities. Next, it proposes an integrated model with an execution plan.FindingsThe first part of the paper discusses how either the planned approach or emergent approach for change may fail in facilitating the implementation of sustainable initiatives, as incorporating sustainability into operations require both leadership of change and open learning systems. The second part outlines the four-phase combined approach, which includes phases of “exploration”, “planning”, “action” and “integration”, and discusses how change readiness is ensured through such approach.Practical implicationsThe authors propose an integrated model as a framework for integrating sustainability into the operations of small health-care facilities. The clearest possible steps at various phases are proposed. Potential barriers and risks are highlighted and the coping strategies proposed to maximise the chance of successfully transforming organisations.Originality/valueApplying the “how to” ideas based on the integrated model for change management will help leaders of health-care facilities gradually integrate sustainability into their day-to-day operations.
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