Computerized Care-Pathways (CCPs) System to Support Person-Centered, Integrated, and Proactive Care in Home-Care Settings

Dubuc, Nicole; Brière, Simon; Corbin, Cinthia; N’Bouke, Afiwa; Bonin, Lucie; Delli-Colli, Nathalie

doi:10.1080/17538157.2020.1865969

Cited by 12 publications

(13 citation statements)

References 35 publications

(38 reference statements)

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“…ICPs are evidence-based tools designed to enhance clinical practices [ 16 ]. Although these tools are known to support interprofessional collaboration by ensuring effective exchange of relevant client data, enabling comprehensive needs assessment, or supporting clinical decision-making [ 39 ] there has been little scholarly attention paid to the extra workload they create for providers.…”

Section: Discussionmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

“…The OCCI has been progressively and partially implemented in home care across the province [ 16 ]. In 2012, the first two phases of OCCI were introduced into clinical information systems used in local health networks [ 16 ]. Then in 2014, the first three phases of OCCI were incorporated in a ministerial computerized clinical management system [ 16 ].…”

Section: Study Contextmentioning

confidence: 99%

“…In 2012, the first two phases of OCCI were introduced into clinical information systems used in local health networks [ 16 ]. Then in 2014, the first three phases of OCCI were incorporated in a ministerial computerized clinical management system [ 16 ]. At its current level of implementation, the OCCI can only support comprehensive needs assessment, data collection and storage , and the care planning for clients and their families [ 16 ].…”

Section: Study Contextmentioning

confidence: 99%

“…These include challenges in using information systems to disseminate clinical tools and to support clinical and administrative decision making while allowing for collective action [ 13 ]; challenges in building effective multidisciplinary clinical teams to carry out a sequential, complementary and interdependent range of activities that are coherently aligned to achieve common goals [ 14 ]; and challenges in strengthening the evidence for clinical and administrative processes used in ICPs [ 15 ]. Important knowledge gaps remain on how ICPs are used to support the daily work of home care providers [ 16 ]. The general objective of this study is to explore the perspectives of home care staff on the use of an ICP to support their efforts to organise and deliver health and social care to community-dwelling older adults with complex needs.…”

Section: Introductionmentioning

confidence: 99%

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Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

et al. 2022

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Background: Integrated care pathways (ICPs) could improve the organisation and delivery of care for community dwelling older adults. An ICP was developed and implemented in Québec to support home care processes. This study explores the perspectives of home care staff on the use of an ICP to support the organisation and delivery of health and social care to community-dwelling older adults with complex needs. Theory and Methods: A case study based on eleven semi-structured interviews and analysis of documents was carried out in an urban home care unit. The Normalization Process Theory was used for mixed thematic analysis. Results: While its capacity to store data and enhance interprofessional information exchange was appreciated by home care staff, the broad scope, and automated features of the ICP tool were often problematic. Concerns about increased provider workloads, disruption to provider-client relationships during clinical encounters, and difficulties engaging clients in decision-making were main obstacles in the use of the ICP. Conclusion: Given the importance of ICPs in advancing clinical integration, it is critical to continuously adjust their design to align with providers’ realities in order to optimize their potential in real life contexts.

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Section: Discussionmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

et al. 2022

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Integrating clinical tools in the continuum of interprofessional collaboration: The providers’ perspectives of an evolving process

Delli-Colli

Belzile

Gagnon

et al. 2022

Journal of Interprofessional Education & Practice

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How Dissemination and Implementation Science Can Contribute to the Advancement of Learning Health Systems

Trinkley¹,

Ho²,

Glasgow³

et al. 2022

Academic Medicine

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Many health systems are working to become learning health systems (LHSs), which aim to improve the value of health care by rapidly, continuously generating evidence to apply to practice. However, challenges remain to advance toward the aspirational goal of becoming a fully mature LHS. While some important challenges have been well described (i.e., building system-level supporting infrastructure and the accessibility of inclusive, integrated, and actionable data), other key challenges are underrecognized, including balancing evaluation rapidity with rigor, applying principles of health equity and classic ethics, focusing on external validity and reproducibility (generalizability), and designing for sustainability. Many LHSs focus on continuous learning cycles, but with limited consideration of issues related to the rapidity of these learning cycles, as well as the sustainability or generalizability of solutions. Some types of data have been consistently underrepresented, including patient-reported outcomes and preferences, social determinants, and behavioral and environmental data, the absence of which can exacerbate health disparities. A promising approach to addressing many challenges that LHSs face may be found in dissemination and implementation (D&I) science. With an emphasis on multilevel dynamic contextual factors, representation of implementation partner engagement, pragmatic research, sustainability, and generalizability, D&I science methods can assist in overcoming many of the challenges facing LHSs. In this article, the authors describe the current state of LHSs and challenges to becoming a mature LHS, propose solutions to current challenges, focusing on the contributions of D&I science with other methods, and propose key components and characteristics of a mature LHS model that others can use to plan and develop their LHSs.

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Computerized Care-Pathways (CCPs) System to Support Person-Centered, Integrated, and Proactive Care in Home-Care Settings

Cited by 12 publications

References 35 publications

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

Integrating clinical tools in the continuum of interprofessional collaboration: The providers’ perspectives of an evolving process

How Dissemination and Implementation Science Can Contribute to the Advancement of Learning Health Systems

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