Lessons Learned - Equity-seeking and collaborative design in the community for persons with cognitive/behavioural disabilities
Notice bibliographique
Résumé
Background: in 5 Canadians do not have a family doctor, and persons with cognitive/behavioural disabilities are even less likely to have suitable access; HIRO therefore collaborated with a diverse working group to develop a sustainable and equitable model of care for clients with cognitive/behavioural disabilities in the community. Approach: This oral presentation is applicable to multiple groups, including; Community-based organizations seeking integrated collaboration (involving regulated workers, unregulated workers, and client voices); Persons with acquired brain injuries, mental illness, and/or behavioural deficits including dementias and developmental populations that can benefit from access to consistent primary care; Policymakers seeking lessons learned for integrated care approaches in the community sector.After completing a literature review and environmental scan including extensive stakeholder consultation, Head Injury Rehabilitation Ontario (HIRO) identified an opportunity to enable more equitable access to primary care for cognitively impaired/behavioural clients. HIRO then applied a co-design approach engaging unregulated staff, allied health clinicians, specialists, primary care providers, an ethics advisor, and clients and families with lived experiences to develop a sustainable and equitable model of care for community clients. During these collaborative sessions individuals were prompted and encouraged for diverse thinking, ethical and moral values analysis, and honest but necessary critical appraisal of status quo; all participants had space to lead different discussions, identify real and perceived barriers, and ultimately all participants contributed to the final model design. Recommendations were summarized, collaborated upon again, and 'finalized' (while recognizing a need for ongoing monitoring and subsequent evolution).The resulting model strengthens partnerships with primary care, home care, and other community providers to improve client care and access. Actions to implement the model included:) Engagement of dedicated Primary Care providers,2) Leadership training and education including role clarity,3) Enhanced client recordkeeping software,4) Embedded interprofessional communication standards, and5) Assigning a dedicated clinician to monitor the implementation and ongoing evolution of client care needs and population health considerations (i.e. to flag when to reconvene/modify the model using a co-design approach again) Results: Almost five years since the transition to this model, initial results suggest:) HIRO clients and their families perceive improved access and quality of care with an integrated community care model,2) HIRO clients reduced the frequency of inappropriate/unnecessary urgent care usage, and3) HIRO unregulated and regulated staff perceived improvement in interdisciplinary collaboration and client care outcomes.Note: The formal mixed-methods analysis will be complete by August 2024.With a dedicated commitment to co-creating and evolving shared values, HIRO enabled integrated quality care for clients with cognitive/behavioural challenges and allowed for opportunities for sustained health and wellness in the community sector. Implications: Despite challenges regarding access to care that may seem daunting, leaders must make the effort to seek out diverse persons with shared values, and to purposefully foster conditions to have generative, collaborative discussions to make systemic change. Without a willingness to share power and humility with a multifaceted group, change can feel like an uphill battle instead of a collaborative design.We recognize the importance of ongoing engagement of providers, clients, and families who embrace innovation, commit to challenging work, forgive mistakes, and continue to work toward the long-term vision and evolution of an integrated community-based model. HIRO is inspired to share its collaborative approach and lessons learned to spread and scale, to promote health equity for others as well.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».