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1.
Worldwide, a growing burden of health and social issues now affect young people. Interagency collaboration and the “integration” of health and social care services are advocated to address the increasingly complex needs of at‐risk youth and to reduce barriers to accessing care. In New Zealand, Youth‐One‐Stop‐Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff. Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different “world views” and cultures of agencies which can run contrary to collaborative practice. Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co‐ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care.  相似文献   

2.
A project designed to teach effective collaboration to professional students in patient-centered health care included as one evaluative measure retrospective interviews with patients, preceptors, and students. This paper analyzes those responses that have implications for social work, reports on the rehabilitation hospital as a social setting, and identifies factors that enhanced or interfered with learning. Interviews highlighted student and preceptor roles as clearly reciprocal and the importance of students bringing to collaborative practice a sense of their own professional identity, skills, and knowledge base as resources to be pooled in team activity.  相似文献   

3.
The relationship between Catholic Social Services (CSS) of the Diocese of Scranton and Mercy Health Partners--Northeast Region, which joined forces last year to develop a senior support network for residents of Wilkes-Barre and the Borough of Kingston, PA, illustrates how collaboration grows out of cooperation and coordination of services. The network is a project of the Neighborhood-Based Senior Care National Initiative, which works to develop collaborations between Catholic health systems and Catholic Charities agencies to help poor communities meet the needs of aging persons. Barriers to successful collaboration may stem from cultural misunderstandings, differences in organizational stability and decision-making processes, attitudes toward money, and even professional vocabularies. Organizations that trust and respect each other can overcome these barriers. The Wilkes-Barre project began simply, but its success established a pattern of cooperation between CSS and Mercy Health Partners, which led to further coordination of referral programs, development of community health profiles, and cross-organizational training. After nine months on the Wilkes-Barre project, CSS and Mercy Health Partners are now developing a Program of All-Inclusive Care for the Elderly (PACE). Effective collaboration between healthcare providers and social service agencies is a long, sometimes difficult, process that requires organizational commitments of time and resources. Organizations must not yield to the temptation to take shortcuts to achieve short-term gains.  相似文献   

4.
Volunteers occupy a specific space in the delivery of palliative care (PC), addressing specific aspects of care and providing a link between professional healthcare providers and informal care. Engaging and empowering these volunteers can be an important strategy to deliver more integrated and comprehensive PC. Insights into current actual volunteer involvement and collaboration across different healthcare services providing generalist and specialist PC is lacking. This study aims to describe volunteers’ involvement in the organisation of PC, collaboration with professionals and how they evaluate this. A cross‐sectional postal survey of volunteers was conducted between June and November 2018 using a written questionnaire. A two‐step disproportionately stratified cluster randomised sample of 2,273 registered volunteers was taken from different strata of healthcare organisations providing care for people with serious illnesses in the Flemish healthcare system (Belgium). Overall response was 35% (15%–60% for individual strata). About 67% of volunteers were often to always informed about the organisation of patient care and 48% felt the organisation often to always takes their opinion into account, while a minority report having decision rights (18%) or autonomy (24%). For some, their organisation failed to inform (17%), consult (27%), take into account their opinion (21%), give them decision rights (20%) or autonomy (16%) over certain aspects of patient care provision often enough. Overall, volunteer–professional collaboration was low, and mostly limited to information sharing. Dedicated PC volunteers collaborated extensively with nurses, often involving task coordination (46%). Ambiguity regarding tasks, agreements and/or rules (15%) and lack of information exchange (14%) were the most cited barriers to volunteer–professional collaboration. Many volunteers were open to stronger involvement in the organisation of care in PC services. Collaboration with professionals seemed lacking in width and depth. Particularly, nursing home volunteers indicated a desire and large potential for more involved and collaborative roles in PC provision.  相似文献   

5.
This paper presents a qualitative approach to studying the reflective learning experiences of health professional students after they participate in an interdisciplinary community-based healthcare course. Over a 2-year period, health professional students from various health-related disciplines voluntarily took an interdisciplinary community-based health course offered at an urban, mid-Atlantic, private university. Through didactic and experiential opportunities, students in the course learned the importance of providing health care services to underserved populations at urban community-based sites. Throughout the semester, students kept journals, completed community response forms, and participated in documented class discussions. A research team of health professional faculty applied constant comparative analyses to the journal entries and community site-visit response forms. Four central themes were identified as the students engaged in learning experiences at various community sites: (1) the need for preventive healthcare; (2) the importance of health services and resources; (3) the awareness of student attitude and behavioral changes; and (4) increased awareness of student and client expectations for health care services. Interpretations of these findings and recommendations for future research are presented.  相似文献   

6.
In some communities, hospital emergency departments are the only places that provide healthcare services to homeless persons. In Dayton, OH, homeless persons have another option--the Samaritan: A Healthcare Clinic for the Homeless. The clinic is a collaborative venture involving the area's public health department, a Fortune 500 business, and a Catholic hospital. In 1991 Dayton's public health department, the Combined Health District (CHD) of Montgomery County, received an anonymous $50,000 donation to provide primary healthcare services to homeless persons. With the goal of generating a number of stakeholders to invest in the community (which would translate into additional volunteers and donations), CHD asked Good Samaritan Hospital, Dayton, if it would become a partner in launching the clinic. Good Samaritan agreed, seeing this as an opportunity to provide a much-needed community service and to fulfill its mission of providing care to the area's needy citizens. In addition, the project was consistent with the hospital's increased focus on primary care. Sponsors of the Samaritan: A Healthcare Clinic for the Homeless anticipate three outcomes resulting from this collaborative effort. First, the cost of healthcare for Dayton's citizens should decrease. Second, providing healthcare services to the homeless enhances the possibility of breaking the cycle of homelessness. Finally, it is critical that healthcare for the homeless become a community focus.  相似文献   

7.
The introduction of top‐down centrally driven solutions to governance of healthcare, at the same time as increasing policy emphasis on greater ‘bottom up’ patient and public involvement in all aspects of healthcare, has set up complex tensions for policy implementation and healthcare practice. This paper explores the interplay of these agendas in the context of changes in primary healthcare services provided by the National Health Service in England. Specifically, it looks at service user involvement in a qualitative study of the professional response to changes in the governance and incentives in the care of people with long‐term conditions. Service users influenced and guided the study at local and national levels. Vignettes of patient stories developed by service users informed in‐depth interviews with 56 health and social care professionals engaged in the development of local policies and services for people with complex long‐term illness, and themes generated by cross case analysis were validated through service users. The findings presented here focus on four themes about risk and comparison of professionals' and service users' perspectives of the issues: managing risks/consistent support, the risks of letting go/feeling in control, professional identity/helping people to help themselves, and managing expectations/professionals losing out. In this study, service user involvement added value by validating understandings of governance, framing debates to focus on what matters at the point of care and enabling perspective sharing and interaction. We suggest that more collaborative forms of governance in healthcare that take account of service user perspectives and enable interaction with professional groups could help validate processes of quality assurance and provide motivation for continuous quality improvement. We offer a model for ‘opening up’ collaborative projects to evaluation and critical reflection of the interrelationships between the context, methods and outcomes of service user involvement.  相似文献   

8.
Older people residents in care homes that only offer residential care rely on primary healthcare services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary healthcare team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on‐site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community‐based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community‐based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to older people who live in their own homes.  相似文献   

9.
Collaboration is an underutilized strategy for combining the strengths and perspective of home health care professionals in service and academic settings. This paper explores the importance of collaborative research strategies, focusing on the role of the unique talents, resources, and perspectives offered by each health professional to the research process. Finally, personal, professional and organizational barriers to collaboration are examined in order to alert would-be researcher collaborators to obstacles they are likely to encounter. When both the strengths of and obstacles to collaborative research are anticipated, collaboration can encourage research that is relevant to the needs and experiences of both home health service providers and academicians.  相似文献   

10.
Collaboration is an underutilized strategy for combining the strengths and perspective of home health care professionals in service and academic settings. This paper explores the importance of collaborative research strategies, focusing on the role of the unique talents, resources, and perspectives offered by each health professional to the research process. Finally, personal, professional and organizational barriers to collaboration are examined in order to alert would-be researcher collaborators to obstacles they are likely to encounter. When both the strengths of and obstacles to collaborative research are anticipated, collaboration can encourage research that is relevant to the needs and experiences of both home health service providers and academicians.  相似文献   

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