Figure 1
Mixed-method approach.
Table 1
Description of the Integrated General-led Hospital (IGH) care model components.
| IGH COMPONENTS | DEFINITION |
|---|---|
| A principal physician | A ‘principal’ physician is identified for every patient admitted to the acute inpatient wards. The principal physician is typically an internal medicine physician or a specialist acting as a generalist. The principal physician uses a holistic approach to ensure all the patients’ needs are addressed. Post-discharge, the principal physician continues to follow-up with the patient in the outpatient setting. |
| Acuity grading | Patients admitted to the inpatient wards are graded on a three-level acuity system: L1 (recovery and rehabilitation), L2 (sub-acute), and L3 (acute). The acuity grading system helps prioritise medical and nursing care. Acuity grading is evaluated daily to reflect patients’ care needs. L1 patients (i.e., those with mainly rehabilitative or social care needs) are typically managed by nurse clinicians, while physicians primarily manage L3 patients. |
| Multidisciplinary team meetings | The multidisciplinary team meetings are weekly meetings involving care team members. Any member of the care team may lead the meeting. The team develops a comprehensive care plan for patients, for inpatient and post-discharge care needs. |
| Care consolidation | Care consolidation seeks to improve care continuity and coordination by i) identifying a principal physician for a patient’s outpatient appointments, and by ii) reducing multiple specialist appointments. Eligibility is assessed upon admission (i.e., multiple morbidities and under the care of multiple specialists). If eligible, nurses introduce the service to patients and/or their families. After discussion, selected specialist appointments are cancelled, and the identified principal physician takes over. Although care is consolidated under a generalist physician, specialist advice is still sought when necessary. |
Table 2
Characteristics of staff survey respondents.
| CHARACTERISTIC (n = 226) | ||
|---|---|---|
| Sex, n (%): | Female | 181 (80) |
| Role, n (%): | Allied Health professional | 9 (4) |
| Care Manager | 4 (2) | |
| Medical Technologist | 7 (3) | |
| Nurse | 135 (60) | |
| Therapist – OT/PT/ST | 13 (6) | |
| Pharmacist | 19 (8) | |
| Physician | 10 (4) | |
| Patient Service Associates (PSA) | 12 (5) | |
| Social Worker | 11 (5) | |
| Other | 6 (3) | |
| Experience, n (%): | <1 year | 29 (13) |
| 1 year to <2 years | 27 (12) | |
| 2 years to <5 years | 57 (25) | |
| 5 years to < 10 years | 30 (13) | |
| ≥10 years | 47 (21) | |
| Unknown | 36 (16) | |
| Employment status, n (%): | Full-time | 217 (96) |
| Full-time (appointed at ≥2 institutions) | 6 (3) | |
| Part-time | 3 (1) | |
| Involved in inpatient care, n (%): | No | 12 (5) |
| Sometimes | 16 (7) | |
| Yes | 198 (88) | |