Quick COVID-19 Primary Care Survey of Clinicians: Summary of the second weekly pan-Canadian survey of frontline primary care clinicians’ experience with COVID-19. (English)

On Friday April 10, the SPOR PIHCI Network, in partnership with the Larry A. Green Center, launched the weekly Canadian Quick COVID-19 Primary Care Survey. Weekly results are available in English and French and an invitation to primary care clinicians across the country to participate opens weekly (http://spor-pihci.com/resources/covid-19/).https://deepblue.lib.umich.edu/bitstream/2027.42/154872/1/PIHCIN-Covid-19-survey series2.pdfDescription of PIHCIN-Covid-19-survey series2.pdf : Main Articl

Can a case lead approach deliver the "craft and graft" of integration?

Purpose: The aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation. Design/methodology/approach: The study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this. Findings: The relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected. Originality/value: The study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments

Quick COVID-19 Primary Care Survey of Clinicians: Summary of the second weekly pan-Canadian survey of frontline primary care clinicians’ experience with COVID-19. (English and French)

On Friday April 10, the SPOR PIHCI Network, in partnership with the Larry A. Green Center, launched the weekly Canadian Quick COVID-19 Primary Care Survey. Weekly results are available in English and French and an invitation to primary care clinicians across the country to participate opens weekly (http://spor-pihci.com/resources/covid-19/).https://deepblue.lib.umich.edu/bitstream/2027.42/154873/1/Wong_week_1_combined.pdfDescription of Wong_week_1_combined.pdf : Main Articl

Quick COVID-19 Primary Care Survey of Clinicians: Summary of the sixth (May 29-June 1, 2020) pan-Canadian survey of frontline primary care clinicians’ experience with COVID-19. (English and French)

On Friday April 10, the SPOR PIHCI Network, in partnership with the Larry A. Green Center, launched the weekly Canadian Quick COVID-19 Primary Care Survey. Weekly results are available in English and French and an invitation to primary care clinicians across the country to participate opens weekly (http://spor-pihci.com/resources/covid-19/). Series 6 results.https://deepblue.lib.umich.edu/bitstream/2027.42/155574/1/6_Combined.pdfDescription of 6_Combined.pdf : Main Articl

A randomised controlled trial of a patient based Diabetes recall and Management system: the DREAM trial: A study protocol [ISRCTN32042030]

BACKGROUND: Whilst there is broad agreement on what constitutes high quality health care for people with diabetes, there is little consensus on the most efficient way of delivering it. Structured recall systems can improve the quality of care but the systems evaluated to date have been of limited sophistication and the evaluations have been carried out in small numbers of relatively unrepresentative settings. Hartlepool, Easington and Stockton currently operate a computerised diabetes register which has to date produced improvements in the quality of care but performance has now plateaued leaving substantial scope for further improvement. This study will evaluate the effectiveness and efficiency of an area wide 'extended' system incorporating a full structured recall and management system, actively involving patients and including clinical management prompts to primary care clinicians based on locally-adapted evidence based guidelines. METHODS: The study design is a two-armed cluster randomised controlled trial of 61 practices incorporating evaluations of the effectiveness of the system, its economic impact and its impact on patient wellbeing and functioning

Making sense of joint commissioning: three discourses of prevention, empowerment and efficiency

Background: In recent years joint commissioning has assumed an important place in the policy and practice of English health and social care. Yet, despite much being claimed for this way of working there is a lack of evidence to demonstrate the outcomes of joint commissioning. This paper examines the types of impacts that have been claimed for joint commissioning within the literature. Method: The paper reviews the extant literature concerning joint commissioning employing an interpretive schema to examine the different meanings afforded to this concept. The paper reviews over 100 documents that discuss joint commissioning, adopting an interpretive approach which sought to identify a series of discourses, each of which view the processes and outcomes of joint commissioning differently. Results: This paper finds that although much has been written about joint commissioning there is little evidence to link it to changes in outcomes. Much of the evidence base focuses on the processes of joint commissioning and few studies have systematically studied the outcomes of this way of working. Further, there does not appear to be one single definition of joint commissioning and it is used in a variety of different ways across health and social care. The paper identifies three dominant discourses of joint commissioning – prevention, empowerment and efficiency. Each of these offers a different way of seeing joint commissioning and suggests that it should achieve different aims. Conclusions: There is a lack of clarity not only in terms of what joint commissioning has been demonstrated to achieve but even in terms of what it should achieve. Joint commissioning is far from a clear concept with a number of different potential meanings. Although this ambiguity can be helpful in some ways in the sense that it can bring together disparate groups, for example, if joint commissioning is to be delivered at a local level then more specificity may be required in terms of what they are being asked to deliver