Cambridge-North Dumfries Ontario Health Team: An Exploratory Evaluation of Service Integration Planning
Notice bibliographique
Résumé
Introduction: Approaches to health care have shifted from individual treatment delivered by one health care provider, to an integrated care approach across health and social sectors involving multiple health care providers who are collaborating across sectors. A main focus of this research was to investigate the planning and development of the Cambridge-North Dumfries Ontario Health Team (CND-OHT). The CND-OHT is currently one of 42 Ontario Health Teams that are being implemented in the province according to integrated care (IC) principles.\nThe exploratory evaluation addressed a gap related to exploring initial planning and development of the CND-OHT IC team. In addition, contextual factors and mechanisms for successful integrated care efforts were explored within the evaluation. The exploratory evaluation answered three research questions. Specifically, how are members engaging in planning and decision making within the CND-OHT? How is the CND-OHT establishing a shared vision between members? And, what are the key components of successful planning and development of the CND-OHT? The exploratory evaluation drew upon realist methods, which provided a lens to understanding facilitators and barriers to IC planning.\nMethods/Research Design: Research methods involved an exploratory evaluation of CND-OHT planning processes and an evaluability assessment (EA), which is a form of exploratory evaluation. A purposive sample of N=18 was recruited from CND-OHT members, where members participated in focus groups and interviews. Thematic analysis was used to determine overarching themes across the dataset.\nResults: Five foundational partnership characteristics that foster transformational planning and integration were identified. Specifically, accountability, appreciation and value of members, optimism and hope, commitment to integration, and a “no ego” mindset. As well as, three components that support the CND-OHT common vision, and three components that hinder the CND-OHT common vision. Components that support the CND-OHT common vision include collaboration, support, and trust. Components that hinder the CND-OHT common vision include, fear and uncertainty to integration, lasting impacts of silos, and a disconnect between the provincial government and the CND-OHT. Finally, four additional components were suggested to support planning and service integration. The additional components that support planning and service integration include goals, incentives, opportunities for member engagement, and shared power.\nDiscussion and Conclusions: The exploratory evaluation provides useful information for the CND-OHT, and other integrated health care teams regarding planning and decision-making processes, and addresses an important gap in the literature in this area. A richer understanding of service integration and planning may encourage IC teams to dedicate time and resources to initial stages of integration that are necessary for success. The study also provides a rationale and context for why IC teams should consider prioritizing the importance of trusting relationships, commitment and a shared common vision.
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,077 | 0,070 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,007 | 0,005 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 source (Gemma direct ou Codex distillé), 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 ».