Table 1
Methodological Design.
| OBJECTIVES | STUDY STAGE | DATA COLLECTION | THEORETICAL PROPOSITIONS FROM LITERATURE | DATA ANALYSIS |
|---|---|---|---|---|
| Description of the OPCS structure/organizational level | Phase I | 20 documents and databases with contextual data | Evaluative framework of integrated care [6] | Directed Content Analysis |
| Identification of the integrative elements that the OPCS includes and excludes at the process of care level | Phase II | 24 Interviews with leaders and care delivery professionals | Scoping review study essential elements of integrated care [22] | Directed Content Analysis |
| Evaluate OPCS degree of integration at both the system organizational and process of care process level | Phase III | Documents and Interviews from this study | Blended model of research and practice [16] | Triangulation |
Table 2
Included Elements in the OPCS Categories and Codes.
| PRELIMINARY CODES | GROUPS OF CODES | SUBCATEGORY | GENERIC CATEGORY | MAIN CATEGORY |
|---|---|---|---|---|
| Various screening tools | NECPAL others screening tools | Shared screening tool | PC standard screening tool | Standard screening tool |
| Identify and label PC patient | PC patient identification | |||
| Information | Multiple information platforms | Multiple Information systems | Shared information system | Information system |
| Multiple information modalities | ||||
| Various documents | Documents shared | Information shared by all | ||
| Various professionals | Competent and qualified prof. | Qualified professionals | Professionals, resources and services | Funding and resources |
| Various services | Existent multiple services | Multiple services | ||
| Communication | Professionals’ coordination | Professionals’ collaboration | PC professionals’ collaboration | Coordination |
| Same vision | Same vision | Professionals’ shared vision | ||
| Patient intervention before complications | Identification/intervention | PC patient effective identification and intervention | PC patient early detection and intervention | Early intervention |
| 24/7 | 24/7 | 24/7 care | PC system continuity of care | Continuity of care |
| Intra-level network | Network continuity | PC continuity | ||
| Leaders | Leaders | Leadership | Supportive policies and leadership | Supportive policies and leadership |
| Dependency law | Policies | Policies | ||
| Case manager | PC case manager identification | Case manager | PC case management | |
| Needs, preferences, opinions | Patient centred | PT preferences | Patient centred PC care | Patient centred |
| PT centred care | PT centred care | |||
| Intermediate care | Intermediate care | PC specialised intermediate care | PC specialised intermediate care | |
| Motivation of professionals | Motivation of professionals | Motivated Professionals | Motivated PC professionals | |
| Interdisciplinary | Multidisciplinary | Multidisciplinary team | Inclusive multidisciplinary team | Multi/interdisciplinary team |
| Education, training | Education/training | Education/training | Education/training | Training and education |
| Implementation | Implementation | PC implementation | PC implementation model | Standard implementation model |
| Specialised care reduces cost | PC services cost | Specialised PC care | Specialised PC cost-efficiency | Cost-efficiency |
Figure 1
Adapted figure. Essential IPCS Elements: Blended Model of Theory and Practice.
Table 3
Included, excluded elements and elements needing improvement in the OPCS to facilitate integration.
| OPCS SERVICE CARE LEVEL VIEW | ||
|---|---|---|
| INCLUDED ELEMENTS | ELEMENTS NEEDING IMPROVEMENT | EXCLUDED ELEMENTS |
| PC standard screening tool | Screening tool difficulties | Volunteer network |
| Shared information system | Better shared information system | |
| Resources, professionals and services | Missing PC funding and resources | |
| Professionals’ collaboration | Need to improve collaboration | |
| Early PC patient detection and intervention | Problems in the process of early PC patient identification and intervention | |
| Continuity of care in the PC system | Problems with continuity of care | |
| Supportive policies and leadership | PC specific policies | |
| PC case management | Need more PC case management | |
| Patient-centred care | Need more patient-centred care | |
| Education and training | Need standardised education and training | |
| PC implementation model | PC standard implementation model difficulties | |
| Inclusive multidisciplinary team | ||
| PC specialised intermediate care | ||
| Motivated PC professionals | ||
| Specialised PC for cost-efficiency | ||
Table 4
Comparison of integration elements at the structure, process of care and Integrated elements in the Blended model.
| ELEMENTS THAT FACILITATE INTEGRATION AT THE STRUCTURAL LEVEL IN THE OPCS | ELEMENTS THAT FACILITATE INTEGRATION AT THE PROCESS OF CARE LEVEL IN THE OPCS | ESSENTIAL ELEMENTS FOR AN INTEGRATED PC SYSTEM IN THE BLENDED MODEL |
|---|---|---|
| Standardised implementation model | PC implementation model | Standard implementation model |
| Multidisciplinary teams | Inclusive multidisciplinary team and | Multidisciplinary team |
| Shared information system | Shared information system | Shared information system |
| Training/education | Education and training | Specialized education and training |
| Standardised screening tool | PC standard screening tool | Screening tool for identifying patients |
| Patient-centered care | Patient-centred care | Patient-centred care |
| Policies and Leadership | Supportive policies and leadership | Supportive leadership and policies |
| PC system cost-efficiency | Specialised PC for cost-efficiency | PC specialized cost-efficiency |
| Continuity of care in the PC system | Continuity of care | |
| Professionals’ collaboration | Collaboration | |
| Motivated PC professionals | Motivated professionals | |
| Early PC patient detection and intervention | Early PC patient detection | |
| PC case management | Case management | |
| Resources, professionals and services | Funding and Resources | |
| PC specialised intermediate care | Empowered patient | |
| Social Services | ||
| Community involvement | ||
| New Integrated PC support team |