Diagnostic study, design and implementation of an integrated model of care in France: a bottom-up process with continuous leadership

نویسندگان

  • Matthieu de Stampa
  • Isabelle Vedel
  • Claire Mauriat
  • Emmanuel Bagaragaza
  • Christelle Routelous
  • Howard Bergman
  • Liette Lapointe
  • Bernard Cassou
  • Joel Ankri
  • Jean-Claude Henrard
چکیده

BACKGROUND Sustaining integrated care is difficult, in large part because of problems encountered securing the participation of health care and social service professionals and, in particular, general practitioners (GPs). PURPOSE To present an innovative bottom-up and pragmatic strategy used to implement a new integrated care model in France for community-dwelling elderly people with complex needs. RESULTS In the first step, a diagnostic study was conducted with face-to-face interviews to gather data on current practices from a sample of health and social stakeholders working with elderly people. In the second step, an integrated care model called Coordination Personnes Agées (COPA) was designed by the same major stakeholders in order to define its detailed characteristics based on the local context. In the third step, the model was implemented in two phases: adoption and maintenance. This strategy was carried out by a continuous and flexible leadership throughout the process, initially with a mixed leadership (clinician and researcher) followed by a double one (clinician and managers of services) in the implementation phase. CONCLUSION The implementation of this bottom-up and pragmatic strategy relied on establishing a collaborative dynamic among health and social stakeholders. This enhanced their involvement throughout the implementation phase, particularly among the GPs, and allowed them to support the change practices and services arrangements.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Diagnostic, design and implementation of an integrated model of care in France: a bottom-up process with a continuous leadership

Purpose: To present an innovative bottom-up and pragmatic strategy used to implement a new integrated care model in France for community-dwelling elderly people with complex needs. Context: Sustaining integrated care is difficult, in large part because of problems encountered securing the participation of health care and social service professionals and, in particular, general practitioners (GP...

متن کامل

ارزیابی تاثیر مدل مراقبت پیگیر بر درمان بیماریهای مزمن

Introduction: Continuous Care Model has been designed and evaluated in relation to patients with chronic coronary artery disease by Ahmadi in 2001. This model consists of four stages of integration: orientation, sensitization, control, and evaluation. This review article aimed to introduce a continuous care model, approaches and perspective model, and explain the results of the articles which u...

متن کامل

Stakeholder Perceptions and Context of the Implementation of Performance-Based Financing in District Hospitals in Mali

Background To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa.   Methods...

متن کامل

A Comprehensive Mathematical Model for the Design of a Dynamic Cellular Manufacturing System Integrated with Production Planning and Several Manufacturing Attributes

    Dynamic cellular manufacturing systems,   Mixed-integer non-linear programming,   Production planning, Manufacturing attributes   This paper presents a novel mixed-integer non-linear programming model for the design of a dynamic cellular manufacturing system (DCMS) based on production planning (PP) decisions and several manufacturing attributes. Such an integrated DCMS model with an extensi...

متن کامل

Improving the Quality of The Integrated Care for The Elderly in A Comprehensive Health Center

Objectives: In elderly care provided by health centers, healthy elderly are neglected in care and education. This qualitative study aimed to standardize healthy ageing care. Methods & Materials: This community-based participatory research with 4 steps (problem detection-design of change programs-implementation of interventions-evaluation) was conducted from 1395 to 1397 in Motahari Health Cent...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 10  شماره 

صفحات  -

تاریخ انتشار 2010