出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Children and young people with chronic and complex conditions have a higher risk of receiving fragmented care and poor experiences of care, which can be due to seeing multiple healthcare providers. Care coordination can provide an improved experience of care by assuming the responsibility for integration of care across multiple care providers, organisations and sometimes geographical boundaries. There is limited literature to our knowledge that explores the experiences of children, young people and their parents/carers of such integrated care, and even less that explores the experiences of health providers’ who are delivering care, despite the importance of understanding the barriers and enablers of integrated service provision to families. Methods : This is a mixed-methods study, using Interpretive Phenomenological Analysis to explore and understand the lived experiences of receiving and delivering integrated care. One-on-one in-depth semi-structured interviews will be conducted with children, young people, parents/carers and health providers, which will be recorded, transcribed and thematically analysed. Participants will be purposively selected from a nurse-led care coordination program called the Connected Care Program (CCP) at a paediatric tertiary hospital in Australia. The CCP caters for children with chronic and complex conditions who see multiple healthcare providers. Parents/carers whose children are enrolled in CCP will be asked to complete a Paediatric Integrated Care Survey [1] which explores their experiences of integrated care using a quantitative approach. Item-level descriptive statistics will be used to evaluate the quantitative data. Results : The results may be unique to what is currently known, due to a gap in the current literature. Even though more organisations are committed to delivering care in a more integrated way, there are still major barriers and this research will determine directly from health providers what these could be. This study aims to determine whether families are experiencing integrated care, and what they wish to experience from the health service. Discussions : It is expected that valuable insights will be gained about the experiences of children, young people, parents/carers and healthcare providers. These insights will contribute to improved family-centred care by informing service planning and delivery, whilst elevating the voice of the child. The findings will be used to review current practices of integrated care provision and will have a direct effect on quality improvement processes. The findings may also be transferable to other paediatric tertiary care coordination programs. Conclusions : This mixed-methods research approach will triangulate the perspectives of children, parents/carers and healthcare providers. The findings of this research will help to improve integrated healthcare service delivery, patient experiences and outcomes, as well as inform service providers about the effect use of healthcare resources. Lessons learned : This research is yet to commence, but results including lessons learned expected by April 2018. Limitations : It is a relatively small sample size Suggestions for future research : Implementation of quality improvement activities as identified by the findings of this research.
关键词：integrated care ; paediatrics ; children ; experience ; family
