Health professionals’ experience of implementing and delivering a ‘Community Care’ programme in metropolitan Melbourne: a qualitative reflexive thematic analysis

Shannon, Brendan; Shannon, Hollie; Bowles, Kelly‐Ann; Williams, Cylie; Andrew, Nadine E.; Morphet, Julia

doi:10.1136/bmjopen-2022-062437

Cited by 6 publications

(9 citation statements)

References 38 publications

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“…In line with Baxter et al ( 21 ), technology can be used as a way to improve safety during the transition. Therefore the use of relatable information support systems in holistic care is essential to support the seamless transfer of electronic medical records and prior visit records between hospital, community, and home care for care coordination ( 54 ). In addition, consistent with previous research, the navigator role needs to be introduced in “siloed” systems as a link between patients, informal caregivers, and health care providers during transitions in the health care system ( 55 ).…”

Section: Discussionmentioning

confidence: 99%

Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives

Sun

Qian

Liu

et al. 2023

Front. Public Health

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BackgroundTransitional care is a critical area of care delivery for older adults with chronic illnesses and complex health conditions. Older adults have high, ongoing care needs during the transition from hospital to home due to certain physical, psychological, social, and caregiving burdens, and in practice, patients' needs are not being met or are receiving transitional care services that are unequal and inconsistent with their actual needs, hindering their safe, healthy transition. The purpose of this study was to explore the perceptions of older adults and health care providers, including older adults, about the transition of care from hospital to home for older patients in one region of China.ObjectiveTo explore barriers and facilitators in the transition of care from hospital to home for older adults in China from the perspectives of older patients with chronic diseases and healthcare professionals.MethodsThis was a qualitative study based on a semi-structured approach. Participants were recruited from November 2021 to October 2022 from a tertiary and community hospital. Data were analyzed using thematic analysis.ResultsA total of 20 interviews were conducted with 10 patients and 9 medical caregivers, including two interviews with one patient. The older adult/adults patients included 4 men and 6 women with an age range of 63 to 89 years and a mean age of 74.3 ± 10.1 years. The medical caregivers included two general practitioners and seven nurses age range was 26 to 40 years with a mean age of 32.8 ± 4.6 years. Five themes were identified: (1) attitude and attributes; (2) better interpersonal relationships and communication between HCPs and patients; (3) improved Coordination of Healthcare Services Is Needed; (4) availability of resources and accessibility of services; and (5) policy and environment fit. These themes often serve as both barriers and facilitators to older adults' access to transitional care.ConclusionsGiven the fragmentation of the health care system and the complexity of care needs, patient and family-centered care should be implemented. Establish interconnected electronic information support systems; develop navigator roles; and develop competent organizational leaders and appropriate reforms to better support patient transitions.

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Section: Discussionmentioning

confidence: 99%

Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives

Sun

Qian

Liu

et al. 2023

Front. Public Health

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“…9,28 The ability to effectively recruit/train multidisciplinary staff with sufficient generalist skills to service the clinical heterogeneity of HITH patients, whilst also enabling the effective management of complex cases is a significant challenge. 29,30 This is worthy of future investigation, especially for services that combine several sub-speciality areas such as acute, rehabilitation and geriatric evaluation and management services.…”

Section: Discussionmentioning

confidence: 99%

Patient and multidisciplinary health professional perceptions of an Australian geriatric evaluation and management and rehabilitation hospital in the home service

Cox,

Kyle,

Suzuki

et al. 2023

J Health Serv Res Policy

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Objectives Hospital in the Home models are rapidly expanding in response to increasing bed pressures. This study examined patient and multidisciplinary health professional perceptions of a new geriatric evaluation and management and rehabilitation hospital in the home service in Australia. The service was unique, as adults of all ages with a variety of rehabilitation or geriatric evaluation and management needs were within scope. Methods A qualitative descriptive approach was used with a consumer co-researcher and a consumer advisor being integral to decision-making. Patient feedback was collected via a paper-based patient satisfaction survey between August 2020 and February 2022. Additionally, interviews with current and past staff were conducted from July to November 2021. Reflexive thematic analysis was conducted for qualitative data and descriptive statistics used for quantitative data. Results Patient surveys were analysed ( n = 199, 42.2% response rate) with 60.8% of participants aged 75 years or over and 26.6% speaking a language other than English. High satisfaction was expressed. Feelings of comfort, familiarity, convenience, and reassurance were voiced. A person-centred approach enhanced involvement in care. Challenges included carer burden and clear communication. Sixteen staff (33% response rate) were interviewed. In general, staff said the service was inclusive and responsive, and the home environment beneficial, particularly for patients from culturally diverse backgrounds. A strong hospital partnership and comprehensive multidisciplinary approach were vital. Challenges included fragmentation due to part-time roles and combining with a pre-existing acute hospital in the home service. Conclusions This qualitative exploration of staff and patients’ perceptions of a geriatrician-led, multidisciplinary geriatric evaluation and management and rehabilitation hospital in the home service demonstrated that it was person-centred and optimised patients’ control and ownership of care. The inclusive service parameters ensured responsiveness to diverse needs whilst allowing earlier return home from hospital, both of which are vital for quality patient care.

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“…1,39 Leveraging change agents, such as programme champions, and utilising social media platforms were found to help promote the value of community paramedicine models of care, dispel misconceptions, and build trust among other healthcare professionals 40 and the community. Prior studies in palliative care 41 and hospital-based readmission risk programmes 42,43 have revealed that common misconceptions regarding the programmes’ roles can be hindered by persistent miscommunication. Overcoming these issues may be achieved through clear purpose statements and the use of change agents to dispel misconceptions.…”

Section: Discussionmentioning

confidence: 99%

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

Shannon,

Batt,

Eaton

et al. 2023

Paramedicine

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Objective This study aims to investigate the experiences of individuals involved in implementing and delivering community paramedicine programmes across several different regions internationally, in order to identify key themes that can inform ongoing development and introduction of community paramedicine programmes. Methods In this study, participants were enlisted through convenience sampling and a snowballing method. They responded to a custom survey emphasising open-ended responses. We employed a qualitative reflexive thematic analysis, utilising an inductive coding technique at the semantic/explicit level. This approach allowed us to discern themes from the participants’ accounts of the programme's implementation and delivery, along with their perceptions of its strengths and challenges. Results Data was collected from 29 participants engaged in the development or delivery of community paramedicine programmes spanning seven countries. Five themes were created: (1) community drives the need, which emphasises the importance of community engagement and flexible response to health needs; (2) working with others, which underscores the necessity of collaboration with stakeholders for integration and relationship maintenance; (3) promotion and communication, focusing on clarifying roles and countering misconceptions; (4) recruitment and support of community paramedics, highlighting the significance of experienced paramedic recruitment and providing support for staff retention; and (5) research and evaluation, stressing the importance of data sharing for patient care and programme evaluation. These themes demonstrate the significance of community-centred approaches, interprofessional practice, and programme evaluation in community paramedicine. Conclusion This study highlights the significance of community-centred approaches, interprofessional practice, and programme evaluation in community paramedicine. These findings can inform policymakers and practitioners in the development and implementation of community paramedicine programmes, ultimately improving the health and well-being of communities across different regions internationally.

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Health professionals’ experience of implementing and delivering a ‘Community Care’ programme in metropolitan Melbourne: a qualitative reflexive thematic analysis

Cited by 6 publications

References 38 publications

Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives

Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives

Patient and multidisciplinary health professional perceptions of an Australian geriatric evaluation and management and rehabilitation hospital in the home service

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

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