Integrated Working for Enhanced Health Care in English Nursing Homes

Abstract

Background: The increasingly complex nature of care home residents' health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England. Study Aims: To explore the views and experiences of practitioners, social care officers, and carers involved in the enhanced health care in care home programme, in order to develop understanding of the service delivery model and associated workforce needs for the provision of health care to older residents. Methods: A qualitative constructivist methodology was adopted. The study had two stages. Stage 1 explored the experiences of the programme enhanced healthcare workforce through group, dyad, and individual interviews with 45 participants. Stage 2 involved two workshops with 28 participants to develop Stage 1 findings (data were collected during February-March 2016). Thematic and content analysis were applied. Findings: The enhanced healthcare programme provides a whole system approach to the delivery of proactive and responsive care for nursing home residents. The service model enables information exchange across organizational and professional boundaries that support effective decision making and problem solving. Clinical Relevance: Understanding of the processes and outcomes of a model of integrated health care between public and independent sector care home services for older people.

Hydration practices in residential and nursing care homes for older people

“…Knowing what hydration strategies work with individual residents requires staff to be highly competent in assessing and responding to the very specific needs of individual residents. Effective multiprofessional working between care home, community and primary care health professionals is also important to optimise the hydration status of residents with complex health and social care requirements (Cook et al, ). Although collaborative working and effective sharing of information and knowledge is essential to workforce competency, team members require a sound knowledge base of hydration practices in the first instance in order to competently contribute to the hydration care of residents.…”

“I'm not sure I'm a nurse”: A hermeneutic phenomenological study of nursing home nurses' work identity

“…There is much evidence to suggest that the health demographics of the NH population is changing. Increasing acuity of residents in NHs means that the NH workforce and those working into NHs increasingly need skills to respond appropriately to health deterioration, deliver relevant clinical interventions and work together effectively with other health professionals if avoidable hospital admissions and unnecessary referrals to community, acute and emergency services are to be further reduced (Cook et al., ; Spilsbury, Hanratty, & McCaughan, ). Faye's and Anne's comments suggest that services offered in NHs are at a point of change and that the NH workforce should reflect the increasingly complex health needs of residents.…”

“…By enhancing health care in NHs, health policy is also attempting to control the economic burden of this population on acute and emergency services (Smith, Sherlaw‐Johnson, Ariti, & Bardsley, ). Implications of these changes include the need for healthcare services and NHs to effectively work in collaboration (Cook et al., ), something which has been difficult to achieve even in counties where integrated health and social care is well established. In their report on the existing integrated care systems in Northern Ireland, Scotland and Wales for the King's Fund, Ham et al.…”

Hydration Interventions for older people living in residential and nursing care homes: overview of the literature

“…homes, not only by the care home team, but through integrated working with multiprofessional healthcare specialists and residents' visitors (including family and friends). A virtual ward team comprised of geriatricians, psychogeriatricians, nutritionists and specialist nurses, working alongside an enhanced community and primary care model of wrapped around care home services offer one approach for proactive case management for enhanced healthcare to be implemented with residents who are struggling to drink sufficient fluids38 .…”