Facilitators and barriers to implementing an acute geriatric community hospital in the Netherlands: a qualitative study.
Background there is a trend across Europe to enable more care at the community level. The Acute Geriatric Community Hospital (AGCH) in the Netherlands in an acute geriatric unit situated in a skilled nursing facility (SNF). It provides hospital-level care for older adults with acute medical conditio...
| Publicado en: | Age & Ageing Vol. 52; no. 1; pp. 1 - 13 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jan2023
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=161698628&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 161698628 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jan2023 vid: 52 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 161698628 10.1093/ageing/afac206 ppf: 1 ppct: 12 formats: tig: atl: Facilitators and barriers to implementing an acute geriatric community hospital in the Netherlands: a qualitative study. aug: au: Ribbink, Marthe E Vries-Mols, Wieteke C B M de Vroomen, Janet L MacNeil Franssen, Remco Resodikromo, Melissa N Buurman, Bianca M group, the AGCH study affil: Amsterdam University Medical Centre, University of Amsterdam, Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands ACHIEVE- Centre of Applied Research, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam , The Netherlands su: Netherlands Hospitals Health facilities Leadership Government regulation Interviewing Medical care costs Medical care Nursing care facilities Human services programs Qualitative research Economics Interprofessional relations Elder care Hospital building design & construction Attitudes of medical personnel Research methodology Patient selection Health insurance reimbursement Medical protocols Thematic analysis sug: subj: Hospitals Health facilities Leadership Government regulation Interviewing Medical care costs Medical care Nursing care facilities Human services programs Qualitative research Economics Interprofessional relations Elder care Netherlands Continuing Care Retirement Communities All Other Outpatient Care Centers General Medical and Surgical Hospitals General (except paediatric) hospitals Commercial and Institutional Building Construction Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Hospital building design & construction Attitudes of medical personnel Research methodology Patient selection Health insurance reimbursement Medical protocols Thematic analysis keyword: community hospital implementation science intermediate care older people qualitative research community hospital implementation science intermediate care older people qualitative research ab: Background there is a trend across Europe to enable more care at the community level. The Acute Geriatric Community Hospital (AGCH) in the Netherlands in an acute geriatric unit situated in a skilled nursing facility (SNF). It provides hospital-level care for older adults with acute medical conditions. The aim of this study is to identify barriers and facilitators associated with implementing the AGCH in a SNF. Methods semi-structured interviews (n = 42) were carried out with clinical and administrative personnel at the AGCH and university hospital and stakeholders from the partnering care organisations and health insurance company. Data were analysed using thematic analysis. Results facilitators to implementing the AGCH concept were enthusiasm for the AGCH concept, organising preparatory sessions, starting with low-complex patients, good team leadership and ongoing education of the AGCH team. Other facilitators included strong collaboration between stakeholders, commitment to shared investment costs and involvement of regulators. Barriers to implementation were providing hospital care in an SNF, financing AGCH care, difficulties selecting patients at the emergency department, lack of protocols and guidelines, electronic health records unsuited for hospital care, department layout on two different floors and complex shared business operations. Furthermore, transfer of acute care to the community care meant that some care was not reimbursed. Conclusions the AGCH concept was valued by all stakeholders. The main facilitators included the perceived value of the AGCH concept and enthusiasm of stakeholders. Structural financing is an obstacle to the expansion and continuation of this care model. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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