Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation
Introduction: Healthcare integration has become prevalent as health systems manage a growing population of older adults with multi-morbid conditions. The integrated general hospital (IGH) is the latest example of how services can be remodelled to achieve greater care integration. Methods: We conduct...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2023-09-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | https://account.ijic.org/index.php/up-j-ijic/article/view/6963 |
| _version_ | 1797655981972258816 |
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| author | Jennifer Sumner Kimberly Teo Cherylanne Tan Sin Hui Neo Lin Hui Lee Brian Ng Yee Wei Lim |
| author_facet | Jennifer Sumner Kimberly Teo Cherylanne Tan Sin Hui Neo Lin Hui Lee Brian Ng Yee Wei Lim |
| author_sort | Jennifer Sumner |
| collection | DOAJ |
| description | Introduction: Healthcare integration has become prevalent as health systems manage a growing population of older adults with multi-morbid conditions. The integrated general hospital (IGH) is the latest example of how services can be remodelled to achieve greater care integration. Methods: We conducted a mixed-method evaluation to identify factors impacting the implementation and effectiveness of the IGH model. Data were collected through in-depth interviews (n = 15) and focus group discussions (n = 8 groups) with hospital staff, and a staff survey (n = 226). Results: Staff perceived improvements in clinical practice and better clinical outcomes for patients. The care model empowered nursing and allied health staff through a more collegial team structure. However, staff reported an unequal workload distribution; a third reported burnout; and some observed inconsistencies between leaders’ aspirations for IGH and what was happening on the ground. For IGH to sustain, staff’s education on the IGH model needs to be improved. Further examination of work processes is recommended to boost staff morale and prevent burnout. Conclusion: Overall, IGH provided better integrated, team-based care. The model challenged traditional team structures and empowered staff to expand their roles and responsibilities. Policymakers could consider the IGH model a successful approach for integrating services across the care continuum. |
| first_indexed | 2024-03-11T17:22:35Z |
| format | Article |
| id | doaj.art-5d32ef928bdc4445ac5cb86098a6e92f |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-03-11T17:22:35Z |
| publishDate | 2023-09-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-5d32ef928bdc4445ac5cb86098a6e92f2023-10-19T08:09:24ZengUbiquity PressInternational Journal of Integrated Care1568-41562023-09-0123131310.5334/ijic.69631124Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method EvaluationJennifer Sumner0https://orcid.org/0000-0002-2200-3275Kimberly Teo1Cherylanne Tan2Sin Hui Neo3Lin Hui Lee4Brian Ng5Yee Wei Lim6https://orcid.org/0000-0003-4686-0738Medical Affairs – Research Innovation & Enterprise, Alexandra Hospital, National University Health SystemMedical Affairs – Research Innovation & Enterprise, Alexandra Hospital, National University Health SystemMedical Affairs – Research Innovation & Enterprise, Alexandra Hospital, National University Health SystemMedical Affairs – Research Innovation & Enterprise, Alexandra Hospital, National University Health SystemNational University of Singapore Institute of Systems Science, Smart Health Leadership CentreNational University of Singapore Institute of Systems Science, Smart Health Leadership CentreDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Medical Affairs – Research Innovation & Enterprise, Alexandra Hospital, National University Health SystemIntroduction: Healthcare integration has become prevalent as health systems manage a growing population of older adults with multi-morbid conditions. The integrated general hospital (IGH) is the latest example of how services can be remodelled to achieve greater care integration. Methods: We conducted a mixed-method evaluation to identify factors impacting the implementation and effectiveness of the IGH model. Data were collected through in-depth interviews (n = 15) and focus group discussions (n = 8 groups) with hospital staff, and a staff survey (n = 226). Results: Staff perceived improvements in clinical practice and better clinical outcomes for patients. The care model empowered nursing and allied health staff through a more collegial team structure. However, staff reported an unequal workload distribution; a third reported burnout; and some observed inconsistencies between leaders’ aspirations for IGH and what was happening on the ground. For IGH to sustain, staff’s education on the IGH model needs to be improved. Further examination of work processes is recommended to boost staff morale and prevent burnout. Conclusion: Overall, IGH provided better integrated, team-based care. The model challenged traditional team structures and empowered staff to expand their roles and responsibilities. Policymakers could consider the IGH model a successful approach for integrating services across the care continuum.https://account.ijic.org/index.php/up-j-ijic/article/view/6963hospital-basedchronic diseasehealth services researchimplementation |
| spellingShingle | Jennifer Sumner Kimberly Teo Cherylanne Tan Sin Hui Neo Lin Hui Lee Brian Ng Yee Wei Lim Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation International Journal of Integrated Care hospital-based chronic disease health services research implementation |
| title | Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation |
| title_full | Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation |
| title_fullStr | Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation |
| title_full_unstemmed | Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation |
| title_short | Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation |
| title_sort | implementing an integrated generalist led inpatient care model results of a mixed method evaluation |
| topic | hospital-based chronic disease health services research implementation |
| url | https://account.ijic.org/index.php/up-j-ijic/article/view/6963 |
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