Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 13;22(1):1.
doi: 10.5334/ijic.5965. eCollection 2022 Jan-Mar.

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

Affiliations

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study

Paul Wankah et al. Int J Integr Care. .

Abstract

Background: Integrated care pathways (ICPs) could improve the organisation and delivery of care for community dwelling older adults. An ICP was developed and implemented in Québec to support home care processes. This study explores the perspectives of home care staff on the use of an ICP to support the organisation and delivery of health and social care to community-dwelling older adults with complex needs.

Theory and methods: A case study based on eleven semi-structured interviews and analysis of documents was carried out in an urban home care unit. The Normalization Process Theory was used for mixed thematic analysis.

Results: While its capacity to store data and enhance interprofessional information exchange was appreciated by home care staff, the broad scope, and automated features of the ICP tool were often problematic. Concerns about increased provider workloads, disruption to provider-client relationships during clinical encounters, and difficulties engaging clients in decision-making were main obstacles in the use of the ICP.

Conclusion: Given the importance of ICPs in advancing clinical integration, it is critical to continuously adjust their design to align with providers' realities in order to optimize their potential in real life contexts.

Keywords: evidence-based clinical tools; home care; integrated care pathways; older adults.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Tasks involved in needs assessment.
Figure 2
Figure 2
Tasks involved in care planning.

References

    1. Briggs AM, Araujo de Carvalho I. Actions required to implement integrated care for older people in the community using the World Health Organization’s ICOPE approach: A global Delphi consensus study. PLoS ONE. 2018. Oct 11; 13(10): 1–16. DOI: 10.1371/journal.pone.0205533 - DOI - PMC - PubMed
    1. Chappell NL, Dlitt BH, Hollander MJ, Miller JA, McWilliam C. Comparative costs of home care and residential care. The Gerontologist. 2004; 44(3): 389–400. DOI: 10.1093/geront/44.3.389 - DOI - PubMed
    1. Tousignant M, Dubuc N, Hébert R, Coulombe C. Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users? Health Soc Care Community. 2007; 15(1): 1–7. - PubMed
    1. Markle-Reid M, Browne G, Gafni A. Nurse-led health promotion interventions improve quality of life in frail older home care clients: Lessons learned from three randomized trials in Ontario, Canada. J Eval Clin Pract. 2013; 19(1): 118–31. DOI: 10.1111/j.1365-2753.2011.01782.x - DOI - PubMed
    1. Boldy D, Grenade L, Lewin G, Karol E, Burton E. Older people’s decisions regarding ‘ageing in place’: A Western Australian case study. Australas J Ageing. 2011; 30(3): 136–42. DOI: 10.1111/j.1741-6612.2010.00469.x - DOI - PubMed

LinkOut - more resources