Integrated working between residential care homes and primary care: a survey of care homes in England.
Integrated working between residential care homes and primary care: a survey of care homes in England.
复制标题
DOI：
10.1186/1471-2318-12-71
复制
发表时间：
2012-11-14
期刊：
影响因子：
4.1
通讯作者：
Goodman C
中科院分区：
文献类型：
--
作者：
Gage H;Dickinson A;Victor C;Williams P;Cheynel J;Davies SL;Iliffe S;Froggatt K;Martin W;Goodman C
由于一系列的医疗状况、心理健康需求和身体虚弱，居住在英格兰养老院的老年人有复杂的健康需求。尽管越来越多的政策期望专业人员应跨组织边界以综合方式运作，但疗养院和国家医疗服务体系 (NHS) 之间对于这两个部门应如何合作缺乏了解，这意味着居民的需求和他们可以获得的服务之间可能会出现“不契合”的情况。本文介绍了一项调查，旨在确定疗养院与初级和社区卫生及社会服务机构之间当前一体化工作的程度。研究团队设计了一份自填式在线问卷。包括不同整合维度（资金、行政、组织、服务提供、临床护理）的项目。该调查于 2009 年对英格兰拥有超过 25 个床位的养老院（n = 621）进行了随机抽样。使用定量和定性方法对答复进行了分析。该调查的总体回应率为15.8%。大多数护理院（78.7%）与不止一家全科诊所合作。受访者表示，过去 6 个月内平均有 14.1 名专业人士/服务人员（全科医生除外）访问过护理院（SD 5.11，中位数 14）；每张床平均有 0.39 (SD.163) 名专业人员/服务人员。最常就诊的服务是地区护理、手足病和社区精神科护士。许多（60%）管理人员认为他们与 NHS 进行了一体化合作，包括共享文件、参与一体化护理规划以及联合学习和培训。然而，一些疗养院管理者指出，工作实践是由 NHS 的服务提供方法和护理优先事项决定的，而不是疗养院或居民的规定，NHS 专业人员缺乏共享信息的意愿，并且对疗养院工作人员的经验和知识缺乏尊重。护理院是各种 NHS 活动的中心，但这是临时性的，没有公认的方式来支持合作。疗养院和当地卫生服务机构之间的整合只有在个人工作关系层面上才真正明显，反映的是协作工作模式，而不是整合模式。疗养院和初级卫生服务机构之间更加一体化的合作有可能以具有成本效益的方式提高护理质量，但需要做出战略决策来制定更正式的安排，以实现这一目标。老年人服务专员需要利用良好的工作关系并解决向护理院提供服务的特殊模式。低答复率表明在护理院进行研究的难度。
Older people living in care homes in England have complex health needs due to a range of medical conditions, mental health needs and frailty. Despite an increasing policy expectation that professionals should operate in an integrated way across organisational boundaries, there is a lack of understanding between care homes and the National Health Service (NHS) about how the two sectors should work together, meaning that residents can experience a poor "fit" between their needs, and services they can access. This paper describes a survey to establish the current extent of integrated working that exists between care homes and primary and community health and social services. A self-completion, online questionnaire was designed by the research team. Items on the different dimensions of integration (funding, administrative, organisational, service delivery, clinical care) were included. The survey was sent to a random sample of residential care homes with more than 25 beds (n = 621) in England in 2009. Responses were analysed using quantitative and qualitative methods. The survey achieved an overall response rate of 15.8%. Most care homes (78.7%) worked with more than one general practice. Respondents indicated that a mean of 14.1 professionals/ services (other than GPs) had visited the care homes in the last six months (SD 5.11, median 14); a mean of .39 (SD.163) professionals/services per bed. The most frequent services visiting were district nursing, chiropody and community psychiatric nurses. Many (60%) managers considered that they worked with the NHS in an integrated way, including sharing documents, engaging in integrated care planning and joint learning and training. However, some care home managers cited working practices dictated by NHS methods of service delivery and priorities for care, rather than those of the care home or residents, a lack of willingness by NHS professionals to share information, and low levels of respect for the experience and knowledge of care home staff. Care homes are a hub for a wide range of NHS activity, but this is ad hoc with no recognised way to support working together. Integration between care homes and local health services is only really evident at the level of individual working relationships and reflects patterns of collaborative working rather than integration. More integrated working between care homes and primary health services has the potential to improve quality of care in a cost- effective manner, but strategic decisions to create more formal arrangements are required to bring this about. Commissioners of services for older people need to capitalise on good working relationships and address idiosyncratic patterns of provision to care homes.The low response rate is indicative of the difficulty of undertaking research in care homes.
登录
查看更多内容
影响因子：
2.8
作者：
Davies SL;Goodman C;Bunn F;Victor C;Dickinson A;Iliffe S;Gage H;Martin W;Froggatt K
通讯作者：
Froggatt K
影响因子：
6.6
作者：
Leutz, WN
通讯作者：
Leutz, WN
影响因子：
2.4
作者：
Goodman, C;Robb, N;Woolley, R
通讯作者：
Woolley, R
影响因子：
4.2
作者：
Goodman, C;Woolley, R;Knight, D
通讯作者：
Knight, D
影响因子：
6.7
作者：
Bowman, C;Whistler, J;Ellerby, M
通讯作者：
Ellerby, M