Abstract:
Introduction:Many care organisations claim to employ multidisciplinary teams, but the term is used to describe quite different forms of collaboration. A systemic view of the work organisation of care delivery is presented and applied in this article that allows to identify and understand often overlooked yet important differences regarding team composition, working relationships and therapeutic relationships. Theory and Methods:We used modern socio-technical systems theory to study care delivery for a particular patient population as a system of interrelated activities. The concept of work organisation refers to the way in which the composite task of care delivery is divided into distinct tasks and how these are grouped in either monodisciplinary or multidisciplinary organisational units. The systemic perspective was applied in a comparative case study of four Multiple Sclerosis hospitals. Results:Among the hospitals, one was characterised by a functional work organisation, with similar tasks grouped in monodisciplinary teams. Cross-disciplinary working and therapeutic relationships were established on an ad hoc basis. The three other hospitals adopted a more process-oriented work organisation (which groups all tasks related to a specific care process within a single, multidisciplinary team). The more process-oriented the work organisation, the more working relationships and therapeutic relationships appeared to be fixed and continuous. Conclusion and discussion:The systemic view adopted in this study yields a better understanding of multidisciplinary teams through the concept of work organisation. The actual composition of multidisciplinary teams, and the related working and therapeutic relationships will vary depending on the type of underlying work organisation. Further validation of this conclusion will be needed in other settings.
journal_name
Int J Integr Carejournal_title
International journal of integrated careauthors
Pless S,Van Hootegem G,Dessers Edoi
10.5334/ijic.3745subject
Has Abstractpub_date
2018-07-05 00:00:00pages
3issue
3issn
1568-4156journal_volume
18pub_type
杂志文章abstract:Background:Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective:To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3292
更新日期:2018-05-25 00:00:00
abstract:INTRODUCTION:Increasing continuity of care has been identified as a strategy to improve patient outcomes, but previous studies of integrated care have tended to focus on pilot areas, which limit their generalisability and the ability to determine in which contexts integrated care was most successful. OBJECTIVE:This st...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2450
更新日期:2016-03-31 00:00:00
abstract:BACKGROUND:Although the need for integrated neighborhood approaches (INAs) is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners' experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Vale...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1596
更新日期:2016-05-12 00:00:00
abstract::By the introduction of a public, mandatory program of Long-Term Care Insurance (LTCI) on April 1, 2000, Japan has moved towards a system of social care for the frail and elderly. The program covers care that is both home-based and institutional. Fifty percent of the insurance is financed from the general tax and the o...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.39
更新日期:2001-01-01 00:00:00
abstract:Introduction:China has adopted a people-centred integrated care model to reform its severely hospital-centric and fragmented delivery system. As a template of this model in urban China, the Luohu Hospital Group has generated considerable public and academic interest to scale it up. Methods:Guided by a policy triangle ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4673
更新日期:2020-03-16 00:00:00
abstract:INTRODUCTION:The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement. METHODS:We organised four nominal groups composed of representatives from ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1975
更新日期:2016-08-19 00:00:00
abstract:INTRODUCTION:In 2002 the Republika Srpska of Bosnia and Herzegovina adopted goals for reducing the burden of chronic disease through a new screening program in its publicly funded health centers ("Dom Zdravljas"). This study evaluated the first year of program implementation. METHODS:The evaluation used in-depth inter...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.227
更新日期:2008-02-11 00:00:00
abstract:PURPOSE:Description and analysis of the effects and side-effects of integrated mental health care in the Netherlands. CONTEXT OF CASE:Due to a number of large-scale mergers, Dutch mental health care has become an illustration of integration and coherence of care services. This process of integration, however, has not ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.198
更新日期:2007-08-27 00:00:00
abstract::The WHO European Office for Integrated Health Care Services in Barcelona is an integral part of the World Health Organizations' Regional Office for Europe. The main purpose of the Barcelona office is within the integration of services to encourage and facilitate changes in health care services in order to promote heal...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION:A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care com...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2944
更新日期:2017-07-21 00:00:00
abstract:INTRODUCTION:The aim of this study is to explore the obstacles to collaborations between nurses in hospital and municipal care in the discharge of hospital patients who need continuing care. METHODS:First, we conducted in-depth interviews of nurses in hospitals and nurses in municipal care. Second, we developed questi...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.858
更新日期:2013-03-14 00:00:00
abstract:PURPOSE:To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. CASE STUDY:The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of Denmark throughout 20...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.187
更新日期:2007-05-30 00:00:00
abstract:INTRODUCTION:Miscommunication and lack of coordination can compromise care quality and patient safety during transitions in care, especially for medically complex older adults. Little research has been done to investigate care transitions from the perspective of those receiving and providing care. METHODS:This study e...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1103
更新日期:2013-06-26 00:00:00
abstract:PROBLEM STATEMENT:Health care delivery in Germany is highly fragmented, resulting in poor vertical and horizontal integration and a system that is focused on curing acute illness or single diseases instead of managing patients with more complex or chronic conditions, or managing the health of determined populations. Wh...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.311
更新日期:2009-04-20 00:00:00
abstract:OBJECTIVES:The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.649
更新日期:2011-07-01 00:00:00
abstract::This paper aims to identify problems in estimating and the interpretation of the magnitude of intervention-related change over time or responsiveness assessed with health outcome measures. Responsiveness is a problematic construct and there is no consensus on how to quantify the appropriate index to estimate change ov...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.65
更新日期:2002-01-01 00:00:00
abstract:PURPOSE:To evaluate the feasibility of regional physical therapy networks including continuing education in rheumatology. The aim of these networks was to improve care provided by primary care physical therapists by improving specific knowledge, technical and communicative skills and the collaboration with rheumatologi...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.108
更新日期:2004-01-01 00:00:00
abstract:Introduction:To meet the needs of vulnerable people, the integration of services across different sectors is important. This paper presents a preliminary review of service integration across sectors in Europe. Examples of service integration between social services, health, employment and/or education were studied. A f...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3107
更新日期:2018-04-19 00:00:00
abstract:INTRODUCTION:The variable success of integrated care initiatives has led experts to recommend tailoring design and implementation to the organizational context. Yet, organizational contexts are rarely described, understood, or measured with sufficient depth and breadth in empirical studies or in practice. We thus lack ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2502
更新日期:2017-06-27 00:00:00
abstract:Introduction:Primary care is increasingly being confronted with complex health care demands stemming from both biomedical and psychosocial problems of people with chronic diseases. Interprofessional collaboration is needed to enhance person-centredness and coordinate care provision in an efficient manner, which should ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4179
更新日期:2018-12-13 00:00:00
abstract:Introduction:Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence is limited regarding...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4635
更新日期:2020-01-20 00:00:00
abstract::HealthOne was part of a state-wide initiative to invest in new community-based facilities for collocating services. The HealthOne Mount Druitt is a virtual hub and spoke organisation established in 2006 in a socially disadvantaged part of Western Sydney based out of a new community health hub. The model is based on 'v...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2243
更新日期:2015-09-23 00:00:00
abstract:Aim:To explore health professionals' perspectives on communication, continuity and between-service coordination for improving cancer care for Indigenous people in Queensland. Methods:Semi-structured interviews were conducted in a purposive sample of primary health care (PHC) services in Queensland with Indigenous and ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.5456
更新日期:2020-06-08 00:00:00
abstract:BACKGROUND:The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions o...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1980
更新日期:2014-12-15 00:00:00
abstract:Introduction:Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursem...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3615
更新日期:2018-01-12 00:00:00
abstract:BACKGROUND:Joint training for interagency working is carried out by Local Safeguarding Children Boards in England to promote effective local working to safeguard and promote the welfare of children. PURPOSE:This paper reports on the findings of the outputs and outcomes of interagency training to safeguard children in ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.548
更新日期:2010-11-16 00:00:00
abstract:Background:Distributive leadership has been proposed as an effective means towards achieving integrated health services. This study draws from the case of Foundry, a network of integrated youth health centres in British Columbia, Canada, and explores the function and impact of distributive leadership in the context of ...
journal_title:International journal of integrated care
pub_type:
doi:10.5334/ijic.4709
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies' perception and expectation. We propose a method for quantifying the agencies' ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.835
更新日期:2012-09-18 00:00:00
abstract:Introduction:Dyspnea is a common complaint and in 70 to 90% the origin is pulmonary or cardiovascular. However, referral to the "wrong" specialism could result in diagnostic- and treatment delay. Integrated care by a cardiologist and a pulmonologist could improve this. The aim of the present study was to evaluate wheth...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3983
更新日期:2018-12-31 00:00:00
abstract:BACKGROUND:As the prevalence of long-term and multimorbid conditions is increasing, patients increasingly require consultations with multiple health care professionals and coordination of their care needs. METHODS:This study is based on a 2011 survey of older Australians which draws on sub-populations of people with d...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1598
更新日期:2015-05-14 00:00:00