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Going round the houses: how can health and social housing sector professionals forge better links and what might the benefits be?
- Author:
- YAXLEY Njoki
- Publisher:
- Clore Social Leadership Programme
- Publication year:
- 2015
- Pagination:
- 22
- Place of publication:
- London
This booklet by the Clore Social Leadership Programme identifies key emerging trends that are impacting on social housing and health professionals. These are: a shift from health care provision in the hospital setting to the home; an increasing need for caseworkers to know more about navigating both health and social housing systems than their clients; the rise of people with long-term complex multi-faceted problems including physical and mental health issues; introspective performance management targets which make driving collaboration increasingly difficult on the frontline; and funding cuts impacting on both sectors – but an acute awareness that the client should still be centre stage. The paper suggests a need to widen the networks of frontline social housing professionals with health sector counterparts in order to increase efficiency and productivity in both sectors and provide people with better levels of care at home. (Edited publisher abstract)
The domiciliary support service in Portugal and the change of paradigm in care provision
- Author:
- SANTANA Silvina
- Journal article citation:
- International Journal of Integrated Care, 7(1), 2007, Online only
- Publisher:
- International Foundation for Integrated Care
In Portugal, the integration of care services is still in its infancy. Nevertheless, a home support service called SAD, provided by non-profit institutions to the elderly population is believed to be a first approach to integrated care. The authors show how health and social care evolved through time, from an integrated approach to separated systems, describing the historical development of the Portuguese health care system and its financing. The article then describes and discusses the services provided by the institutions that participate in SAD and examines whether this service is the first step in a change towards integrated care. The main data sources were documents provided by institutions like INE (Instituto Nacional de Estatística—National Institute of Statistics) and a questionnaire that was submitted to 75 institutions in order to capture: (a) demographic and structural data; (b) the type of information that the professionals need to fulfil their jobs and (c) the kind of relationship and constraints, if they exist, to better integration, between the institutions that provide SAD and the patients, the social and health systems, and other entities. It is concluded that SAD seems to have been promoting a formal collaboration between several entities in the social and health systems. The information shared between these institutions has increased, but where cooperation in care service provision is concerned this seldom surpasses the social bounds because health care is still difficult to integrate.
Elderly people's integrated care system (EPICS): general description
- Author:
- HELEN HAMLYN FOUNDATION
- Publisher:
- Helen Hamlyn Foundation
- Publication year:
- 1991
- Pagination:
- 46p.,bibliog.
- Place of publication:
- London
EPICS aims to provide comprehensive, locally based, integrated health, social and personal care for older people living at home. The framework of the scheme is outlined, together with practical issues.
Sheffield shows the way
- Authors:
- MacDONALD R., et al
- Journal article citation:
- Community Care, 18.10.84, 1984, pp.28-30.
- Publisher:
- Reed Business Information
Sheffield's, and the country's, first elderly persons support unit (EPSU) offers integrated services to the elderly at one location, from routine domiciliary care to comprehensive care in a residential setting.
Avoiding unnecessary hospital admissions: the headlines
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2012
- Place of publication:
- London
This film explores the challenge of reducing hospital admissions for older people through contributions from a range of health and social care experts. Their reflections highlight the complex health needs of older people in this country, the need for responsive and joined up health and social care services, and the role that home care staff can play in helping to identify deteriorating conditions that may result in a hospital admission. The film acknowledges that at a crisis point, hospital admission may be the only safe alternative but argues that integrated care, well-managed hospital stays, improved health provision in care homes, reablement, and self-management of health conditions can all play a part in reducing hospital admissions. The film will be of interest to health and social care commissioners and managers; social workers; GPs and community nurses; health and social care providers; health and social care policy leads.
Implementation of home hospitalization and early discharge as an integrated care service: a ten years pragmatic assessment
- Authors:
- HERNANDEZ Carme, et al
- Journal article citation:
- International Journal of Integrated Care, 18(2), 2018, p.12. Online only
- Publisher:
- International Foundation for Integrated Care
Home Hospitalization has proven efficacy, but its effectiveness and potential as an Integrated Care Service in a real world setting deserves to be explored. Objective: To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona. Methods: Prospective study with pragmatic assessment. Patients: Surgical and medical acute and exacerbated chronic patients requiring admission into a highly specialized hospital, from 2006 to 2015. Intervention: Home-based individualized care plan, administered as a hospital-based outreach service, aiming at substituting hospitalization and implementing a transitional care strategy for optimal discharge. Main measurements: Emergency Department, readmissions and mortality. Patients’ and professionals’ perspectives, technologies and costs were evaluated. Results: 4,165 admissions (71 ± 15 yrs; Charlson Index 4 ± 3). In-hospital stay was 1 (0–3) days and the length of home-based stay was 6 (5–7) days. The 30-day readmission rate was 11% and mortality was 2%. Patients, careers and health professionals expressed high levels of satisfaction (98%). At the start, the service was reimbursed at a flat rate of 918€ per patient discharged, significantly lower than conventional hospitalization (2,879€) but still allowing the hospital to keep a balanced budget. At present, there is no difference in the payment schemes for both types of services. Conclusions: The service freed an average of 6 in-hospital days per patient. The program showed health value generation, as well as potential for synergies with community-based Integrated Care Services. (Edited publisher abstract)
The development of an evaluation framework for a Hospital at Home service: lessons from the literature
- Authors:
- JESTER Rebecca, et al
- Journal article citation:
- Journal of Integrated Care, 23(6), 2015, pp.336-351.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to share good practice with interested professionals, commissioners and health service managers regarding the development of an evidence-based approach to evaluation of an integrated care service providing acute level care for patients in their own homes in South London called the Guys and St Thomas’ @home service. Design/methodology/approach: A literature review related to Hospital at Home (HH) schemes was carried out with an aim of scoping approaches used during previous evaluations of HH type interventions to inform the development of an evaluation strategy for @home. The results of the review were then applied to the Donabedian conceptual model: Structure; Process; and Outcome and contextualised to the population being served by the scheme to ensure a robust, practical and comprehensive approach to evaluation. Findings: Due to the heterogeneity of the studies it was not possible to conduct a systematic review or meta-analysis. In total, 28 studies were identified that met the inclusion criteria and included both HH to facilitate early discharge and admission prevention across a wide range of conditions. The key finding was there is a dearth of literature evaluating staff preparation to work on HH, models of delivery, specifically integrated care and trans-disciplinary working and few studies included the experiences of family carers. Originality/value: This paper will be of value to those involved in the commissioning and delivery of HH and other models of integrated care services type services and will help to inform evaluation strategies that are practical, evidence based and include all stakeholder perspectives. (Publisher abstract)
Bringing care home: the Guinness partnership
- Authors:
- SKILLS FOR CARE, HOUSING LEARNING AND IMPROVEMENT NETWORK
- Publisher:
- Skills for Care
- Publication year:
- 2014
- Pagination:
- 6 mins 3 seconds
- Place of publication:
- Leeds
This short film film looks at how adult care and housing services can integrate their work to improve the quality of life for those with care and support needs. This video focuses on Fitzwilliam Court in Hoyland, South Yorkshire where on site domiciliary care enablers support people who live there to lead independent lives, maximising their choice and control. The film was made by Skills for Care and the Housing Learning and Improvement Network. (Edited publisher abstract)
Development of integrated care pathways: toward a care management system to meet the needs of frail and disabled community-dwelling older people
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- International Journal of Integrated Care, 13(2), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
The home care and services provided to older adults with the same needs are often inadequate and highly varied. Integrated care pathways (ICPs) can resolve these issues. The aim of this study was to develop the content of electronic ICPs to ensure the follow up frail and disabled community-dwelling older people in Canada. A rigorous process was applied according to a series of steps: identification of desirable characteristics and a theoretical framework; review of evidence-based practices and current practices; and determination of ICPs by an interdisciplinary task team. In order to prevent specific problems, maximize independence, and promote successful aging, the ICPs followed five phases: (1) needs assessment and assessment of risk/protection factors; (2) data-collection summary and goals identification; (3) planning of interventions from a client-centered view; (4) coordination, delivery, and follow-up; and (5) identification of variances, as well as review and adjustment of plans. Once computerized, these ICPs will facilitate the exchange of information as well as the clinical decision-making process with a perspective to adequately matching the needs of an individual person with resources that delay or slow the progression of frailty and disability. Once aggregated, the data will also support managers in organizing teamwork and follow-up for clients. (Publisher abstract)
Service coordination for frail elderly individuals: an analysis of case management practices in Québec
- Author:
- CARRIER Sébastien
- Journal article citation:
- Journal of Gerontological Social Work, 55(5), July 2012, pp.392-408.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In Québec, case management is responsible for the interprofessional and interorganisational coordination of integrated services networks for frail elderly individuals with both intense and multidimensional home care needs. Case management is designed to come into action early in the disability process to maintain home care as long as possible and avoid institutionalisation. The aim of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, the goal is to describe practical coordination processes. A qualitative exploratory study was conducted using an embedded case study design in 3 Health and Social Services Centres in Québec. In each institution, 3 data collection methods were used: documentary analysis of the prescribed coordination processes; interviews of case managers to determine actual coordination practices; and direct observation of professional practices. The findings showed that case management is more frequently justified by a situation in which home care is precarious rather than by the intensity and multidimensionality present in a situation. Therefore, it fails to address the fundamental goal of general coordination, which is proactive and continuous, instead acting in ‘standby mode’.