Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs

• Published in: Journal of multidisciplinary healthcare 2024-01, Vol.17, p.2879-2890
• Main Authors: Gustafsson, Lena-Karin, Anbacken, Els-Marie, Östlund, Gunnel, Bondesson, Anna, Pettersson, Tina, Zander, Viktoria
• Format: Article
• Language: English
• Subjects: Analysis; Home care; home-based care; integrated-care model; interprofessional care; Medical care; multi-morbidity; Original Research; person-centred integrated care; Professional workers; Quality management
• ISSN: 1178-2390; 1178-2390
• DOI: 10.2147/JMDH.S455935

This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people's homes. Open-ended group interviews with personnel were carried out, three of the group interviews pre-implementations of the model, and three of the group interviews post-implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis. The quality of the integrated care model was based on care-chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person-centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants' experiences of the post-implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting. Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question.