The meaning of continuity of care from the perspective of older people with complex care needs–A scoping review

Djukanovic, Ingrid; Hellström, Amanda; Wolke, Anna; Schildmeijer, Kristina

doi:10.1016/j.gerinurse.2023.12.016

Cited by 3 publications

(1 citation statement)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fragmentation of care is a key concern for people with complex needs, such as multimorbidity or frailty [ 35 ] and further rapid expansion of innovations by different players (industry, third sector, healthcare, social care) is likely to fragment care further. There is increasing evidence of the importance of continuity of care [ 36 ] yet in the systems currently in operation in Scotland and England, the role of ‘care-coordinator’ is often left to individuals and families [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

New models of health and social care for people in later life: mapping of innovation in services in two regions of the United Kingdom using a mixed method approach

Frost,

Tooman,

Aujla

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Innovation for reforming health and social care is high on the policy agenda in the United Kingdom in response to the growing needs of an ageing population. However, information about new innovations of care being implemented is sparse. Methods We mapped innovations for people in later life in two regions, North East England and South East Scotland. Data collection included discussions with stakeholders (n = 51), semi-structured interviews (n = 14) and website searches that focused on technology, evaluation and health inequalities. We analysed qualitative data using framework and thematic analyses. Quantitative data were analysed descriptively. Results One hundred eleven innovations were identified across the two regions. Interviewees reported a wide range of technologies that had been rapidly introduced during the COVID-19 pandemic and many remained in use. Digital exclusion of certain groups of older people was an ongoing concern. Innovations fell into two groups; system-level ones that aimed to alleviate systems pressures such as preventing hospital (re)admissions, and patient-level ones which sought to enhance health and wellbeing directly. Interviewees were aware of the importance of health inequalities but lacked data to monitor the impact of innovations on these, and evaluation was challenging due to lack of time, training, and support. Quantitative findings revealed that two thirds of innovations (n = 74, 67%) primarily focused on the system level, whilst a third (n = 37, 33%) primarily focused on the patient-level. Overall, over half (n = 65, 59%) of innovations involved technologies although relatively few (n = 12, 11%) utilised advanced technologies. Very few (n = 16, 14%) focused on reducing health inequalities, and only a minority of innovations (n = 43, 39%) had undergone evaluation (most of which were conducted by the service providers themselves). Conclusions We found a wide range of innovative care services being developed for people in later life, yet alignment with key policy priorities, such as addressing health inequalities, was limited. There was a strong focus on technology, with little consideration for the potential to widen the health inequality gap. The absence of robust evaluation was also a concern as most innovations were implemented without support to monitor effectiveness and/or without plans for sustainability and spread.

show abstract

Section: Discussionmentioning

confidence: 99%

New models of health and social care for people in later life: mapping of innovation in services in two regions of the United Kingdom using a mixed method approach

Frost,

Tooman,

Aujla

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

Content validity of patient-reported measures evaluating experiences of the quality of transitions in healthcare settings—a scoping review

Walløe,

Roikjær,

Hansen

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

No reviews so far have been conducted to define the constructs of patient-experienced quality in healthcare transitions or to identify existing generic measures of patients’ experience of the quality within healthcare transitions. Our aim was to identify domains relevant for people experiencing healthcare transitions when evaluating the quality of care they have received, map the comprehensiveness of existing patient-reported experience measures (PREM), and evaluate the PREMs’ content validity. The method was guided by the Joanna Briggs Institutes’ guidance for scoping reviews. The search was performed on 07 December 2021 and updated 27 May 2024, in the electronic databases Medline (Ovid), Embase (Ovid), and Cinahl (EBSCO). The search identified 20,422 publications, and 190 studies were included for review. We identified 30 PREMs assessing at least one aspect of adults’ experience of transitions in healthcare. Summarising the content, we consider a model with two domains, organisational and human-relational, likely to be adequate. However, a more comprehensive analysis and adequate definition of the construct is needed. None of the PREMs were considered content valid.

show abstract

Identifying and prioritizing recommendations to optimize transitions across the care journey for hip fractures: Results from a mixed-methods concept mapping study

Guilcher,

Cadel,

Everall

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Individuals who experience a hip fracture have numerous care transitions. Improving the transition process is important for ensuring quality care; however, little is known about the priorities of different key interest groups. Our aim was to gather recommendations from these groups regarding care transitions for hip fracture. Methods We conducted a concept mapping study, inviting persons with lived experience (PWLE) who had a hip fracture, care partners, healthcare providers, and decision-makers to share their thoughts about ‘what is needed to improve care transitions for hip fracture’. Individuals were subsequently asked to sort the generated statements into conceptual piles, and then rate by importance and priority using a five-point scale. Participants decided on the final map, rearranged statements, and assigned a name to each conceptual cluster. Results A total of 35 participants took part in this concept mapping study, with some individuals participating in multiple steps. Participants included 22 healthcare providers, 7 care partners, 4 decision-makers, and 2 PWLE. The final map selected by participants was an 8-cluster map, with the following cluster labels: (1) access to inpatient services and supports across the care continuum (13 statements); (2) informed and collaborative discharge planning (13 statements); (3) access to transitional and outpatient services (3 statements); (4) communication, education and knowledge acquisition (9 statements); (5) support for care partners (2 statements); (6) person-centred care (13 statements); (7) physical, social, and cognitive activities and supports (13 statements); and (8) provider knowledge, skills, roles and behaviours (8 statements). Conclusions Our study findings highlight the importance of person-centred care, with active involvement of PWLE and their care partners throughout the care journey. Many participant statements included specific ideas related to continuity of care, and clinical knowledge and skills. This study provides insights for future interventions and quality improvement initiatives for enhancing transitions in care among hip fracture populations.

show abstract

The meaning of continuity of care from the perspective of older people with complex care needs–A scoping review

Cited by 3 publications

References 38 publications

New models of health and social care for people in later life: mapping of innovation in services in two regions of the United Kingdom using a mixed method approach

New models of health and social care for people in later life: mapping of innovation in services in two regions of the United Kingdom using a mixed method approach

Content validity of patient-reported measures evaluating experiences of the quality of transitions in healthcare settings—a scoping review

Identifying and prioritizing recommendations to optimize transitions across the care journey for hip fractures: Results from a mixed-methods concept mapping study

Contact Info

Product

Resources

About