Abstract
Background:The impact of integrated working on professionals’ objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding.Methods:A quasi-experimental design with a control group was used. Data regarding objective burden involved the professionals’ time investments over a 12-month period that were collected from patient medical records (n = 377) time registrations, transcripts of meetings and patient questionnaires. Data regarding job satisfaction were collected using questionnaires that were distributed to primary care and home-care professionals (n = 180) after the intervention’s implementation. Within- and between-groups comparisons and regression analyses were performed.Results:Non-patient related time was significantly higher in the experimental group than in the control group, whereas patient-related time did not differ. Job satisfaction remained unaffected by the intervention.Conclusion and Discussion:Integrated working is likely to increase objective burden as it requires professionals to perform additional activities that are largely unrelated to actual patient care. Implications for research and practice are discussed. [Current Controlled Trials ISRCTN05748494].
Highlights
Integration is emerging as a central tenet of health systems [1]
Professionals are increasingly required to deliver integrated care, with respect to the growing population of community-dwelling frail elderly patients that are in need of complex and long-term care services from multiple organisations and providers [1,2,3]
The experimental group consisted of 3 primary care practices located in eastern Walcheren that provided care according to the intervention, and the control group consisted of 5 primary care practices located in northern, southern and western Walcheren that provided care as usual
Summary
Integration is emerging as a central tenet of health systems [1]. As a result, professionals are increasingly required to deliver integrated care, with respect to the growing population of community-dwelling frail elderly patients that are in need of complex and long-term care services from multiple organisations and providers [1,2,3]. Integrated care is generally defined as a ‘coherent set of methods and models on the funding, and the administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment, and collaboration within and between the cure and care sectors’ [3]. It involves a shift from the traditional and hierarchical organisation of care based on clinical disciplines towards patient-centred care delivery based on horizontal work processes [4,5,6]. Implications for research and practice are discussed. [Current Controlled Trials ISRCTN05748494]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
