Strengthening Patient-Centered Care in the VHA: A Relational Model of Change

Gittell, Jody Hoffer; Hajjar, Lauren

doi:10.1007/s11606-019-04996-7

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…These improvement contributed positively to discussions and resulted in better treatment plans. These findings are in line with previous study findings [ 47 48 ]. Another observation was the improvement in case coordination due to the more complete presence of required disciplines during the MDTM and the better relationships.…”

Section: Discussionsupporting

confidence: 94%

“…The interviews provided an insight into the complex dynamics of oncology care pathways and the functioning of their MDTMs. Collaboration in an MDTM is not only about efficiency and indicators like throughput times, but also about cooperation, respect for other team members and the commitment of all team members, and good leadership [ 12 48 60 ].…”

Section: Discussionmentioning

confidence: 99%

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Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation

et al. 2021

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Introduction: The reorganisation of the structure of a Gastro-Intestinal Oncology Multidisciplinary Team Meeting (GIO-MDTM) in a tertiary centre with three care pathways is evaluated on added value. Methods: In a mixed method investigation, process indicators such as throughput times were analysed and stakeholders were interviewed regarding benefits and drawbacks of the reorganisation and current MDTM functioning. Results: For the hepatobiliary care pathway, the time to treatment plan increased, but the time to start treatment reduced significantly. The percentage of patients treated within the Dutch standard of 63 days increased for the three care pathways. From the interviews, three themes emerged: added value of MDTMs, focus on planning integrated care and awareness of possible improvements. Discussion: The importance of evaluating interventions in oncology care pathways is shown, including detecting unexpected drawbacks. The evaluation provides insight into complex dynamics of the care pathways and contributes with recommendations on functioning of an MDTM. Conclusions: Throughput times are only partly determined by oncology care pathway management, but have influence on the functioning of MDTMs. Process indicator information can help to reflect on integration of care in the region, resulting in an increase of patients treated within the Dutch standard.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation

et al. 2021

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“…If we assume that the main purpose of PACO is to promote patients' health and recovery, investment in strategies to improve patients' experience in these facilities can lead to positive outcomes. The PPE results provide actionable indicators, such as communication, comfort, and respect, to monitor and improve situations [21], but organizational characteristics, such as a person-centred climate [31] and relational coordination [32,33], should also be included in improvement efforts.…”

Section: Discussionmentioning

confidence: 99%

From hospital to post-acute care organizations: the relationship between patient experience and health recovery

Nascimento

Nunes

Anderson

2020

International Journal for Quality in Health Care

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Objective To determine to what extent patient health status and recovery in post-acute care organizations (PACO) is related to patient experience of the discharge process from hospital and to patient experience while staying in these facilities. Design Longitudinal study of patients discharged from hospitals to post-acute care organizations. Setting 12 hospitals and 14 PACO Portuguese organizations. Participants 181 patients participated in the both stages of data gathering. Main Outcome Measures Patients’ physical and mental health status was measured through the SF-36 scale. The experience of transition from hospital to post-acute care organizations was measured with the Care Transition Measure. The Picker Adult In-Patient Questionnaire was used to measure patients’ experience in these organizations. Results Patients reporting better physical condition in post-acute care organizations had a better experience on discharge [b = 0.21, 95% CI (0.10, 0.31)] and perceive fewer problems inside facilities [b = -0.19, 95% CI (-0.31, 0.08)]. The experience in post-acute care organizations is significantly related to patients’ mental health status [b = -0.47, 95% CI (-0.59, -0.36)]. Patients showing higher levels of physical recovery had a better experience on discharge [b = -0.18, 95% CI (0.08, 0.28)], while those registering better mental recovery experienced fewer problems during their stay [b = -0.41, 95% CI (-0.52, -0.30)]. Conclusions PACO play a key role in maintaining and promoting patients’ health and this goal is influenced by their experience both in the transition from hospitals to PACO and while staying in these facilities.

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“…The work supports current VA priorities including a focus on patient centered care, learning healthcare systems and high reliability organizing. 10,11,12 Relational coordination is an empirically supported theory of organizational performance that proposes interdependent work is most effectively coordinated by workers with each other, their customers, and their leaders. 13 Relational coordination drives performance outcomes including quality, e ciency, client satisfaction, worker well-being and engagement.…”

Section: Introductionmentioning

confidence: 99%

A Dissemination Strategy to Promote Relational Coordination in the Veterans Health Administration: A Case Study

Connelly

Battaglia²,

Gilmartin

2020

Preprint

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BackgroundImplementing new healthcare practices across large organizations can be difficult due to inefficient diffusion of information. Using social marketing theory and additional evidence-based dissemination strategies, we spread relational coordination, an empirically supported theory of organizational performance, throughout the large Veterans Health Administration (VA). Relational Coordination drives performance outcomes including quality, efficiency, client satisfaction, and worker well-being and engagement and proposes interdependent work is most effectively coordinated by workers with each other, their customers, and their leaders. We aimed to develop a best-practice dissemination plan to educate and motivate researchers and operational staff in the VA to study and implement relational coordination within their programs of research or areas of operation.MethodsIn this observational case study, we followed the four Ps of social marketing theory to develop a strategy to disseminate relational coordination across the VA in two phases. In phase one, we created and distributed relational coordination information and invited VA staff to join the Relational Coordination Research Collaborative. In phase two dissemination efforts targeted researchers who were ready to study and implement relational coordination within existing programs of research. Primarily observational data were collected through both stages of the project and a final, post-project survey was administered after the second phase. The quantitative results were calculated using descriptive statistics and text responses in the survey were analyzed using deductive content analysis. A structured categorization matrix was developed to code the responses based on the survey questions. ResultsThe first phase saw instances of social media dissemination, presentations, as well as phone or email communication between project staff and the target audience. 47 members of VA staff joined the Relational Coordination Research Collaborative and 50% participated in online research seminars. 13 research projects applied for the second stage and 5 projects were ultimately chosen to access the Relational Coordination survey. Relational coordination-related trainings, presentations, and publications also occurred.ConclusionsDissemination approaches that involved personalized, one-on-one efforts seemed to be more effective at spreading relational coordination compared to social media or other online presentations. Participants in the second phase overwhelmingly agreed to that relational coordination should be adopted in the VA but indicated the cost of the program would have been a barrier. Results reiterate the importance of an intentional dissemination plan, including addressing the costs and benefits of programs

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Strengthening Patient-Centered Care in the VHA: A Relational Model of Change

Cited by 17 publications

References 10 publications

Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation

Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation

From hospital to post-acute care organizations: the relationship between patient experience and health recovery

A Dissemination Strategy to Promote Relational Coordination in the Veterans Health Administration: A Case Study

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