Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

International Journal of Integrated Care

Rachael Corser¹  Lesley Baillie²  Andrew Gallini³  Annabelle Barrand⁴  Gina Elworthy⁴  Ann Scotcher⁴ 

[1] Buckinghamshire Healthcare NHS Trust;London South Bank University and University College London Hospitals;St Johns's Hospice;University of Bedfordshire;

关键词: vertical integration, integrated care, frail older people, care transitions, acute hospital wards, community healthcare;   

DOI  :  10.5334/ijic.1175

来源: DOAJ

【 摘 要 】

Introduction: Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services.

Theory and methods: The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n =17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings: Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions.

Discussion and conclusions: A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other’s roles and build relationships and trust.

【 授权许可】

Unknown