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Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?

BACKGROUND: Even though nurses are expected to play a key role in implementing integrated services networks, up to now their practice in this regard has received very little research attention. The aim of this study is to describe the extent to which the evolution of nursing practice in Quebec in re...

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Autores principales: Longpré, Caroline, Dubois, Carl-Ardy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359500/
https://www.ncbi.nlm.nih.gov/pubmed/25884845
http://dx.doi.org/10.1186/s12913-015-0720-8
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author Longpré, Caroline
Dubois, Carl-Ardy
author_facet Longpré, Caroline
Dubois, Carl-Ardy
author_sort Longpré, Caroline
collection PubMed
description BACKGROUND: Even though nurses are expected to play a key role in implementing integrated services networks, up to now their practice in this regard has received very little research attention. The aim of this study is to describe the extent to which the evolution of nursing practice in Quebec in recent years has converged with the requirements and efforts involved in services integration. METHODS: This descriptive study was carried out with 107 nurses working an integrated network of healthcare services in Quebec in four different care pathways: chronic obstructive pulmonary disease, autonomy support for the elderly, palliative oncology care, and mental health. Development model for integrated care (DMIC) was used, first, to examine the prevalence in each pathway of integrative activities, grouped into nine practice dimensions, and then to position each pathway in relation to the four phases of development for any integration process, as defined by the DMIC. RESULTS: Only one pathway had reached Phase 3, which involves expansion and monitoring of integration, whereas the others were still in the preliminary Phases 1 and 2 characterized by initiative and experimentation. Only two dimensions out of nine (‘quality of care’ and ‘interprofessional teamwork’) were prevalent in all the pathways; two others (‘transparent entrepreneurship’ and ‘performance management’) were in none of the pathways, and the remaining five (‘patient–family centered care’, ‘result-focused learning’, ‘delivery system’, ‘commitment’, ‘roles and tasks’) were present to varying degrees. CONCLUSIONS: These results suggest that particular efforts should be made to bridge the significant gap between the pace of nursing practice transformation and the objectives of service integration. These efforts should focus, among other things, on the deployment of organizational, clinical, human, and material resources to support practice renewal and continuing education for nurses to prepare them for the requirements of integration. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0720-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-43595002015-03-15 Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence? Longpré, Caroline Dubois, Carl-Ardy BMC Health Serv Res Research Article BACKGROUND: Even though nurses are expected to play a key role in implementing integrated services networks, up to now their practice in this regard has received very little research attention. The aim of this study is to describe the extent to which the evolution of nursing practice in Quebec in recent years has converged with the requirements and efforts involved in services integration. METHODS: This descriptive study was carried out with 107 nurses working an integrated network of healthcare services in Quebec in four different care pathways: chronic obstructive pulmonary disease, autonomy support for the elderly, palliative oncology care, and mental health. Development model for integrated care (DMIC) was used, first, to examine the prevalence in each pathway of integrative activities, grouped into nine practice dimensions, and then to position each pathway in relation to the four phases of development for any integration process, as defined by the DMIC. RESULTS: Only one pathway had reached Phase 3, which involves expansion and monitoring of integration, whereas the others were still in the preliminary Phases 1 and 2 characterized by initiative and experimentation. Only two dimensions out of nine (‘quality of care’ and ‘interprofessional teamwork’) were prevalent in all the pathways; two others (‘transparent entrepreneurship’ and ‘performance management’) were in none of the pathways, and the remaining five (‘patient–family centered care’, ‘result-focused learning’, ‘delivery system’, ‘commitment’, ‘roles and tasks’) were present to varying degrees. CONCLUSIONS: These results suggest that particular efforts should be made to bridge the significant gap between the pace of nursing practice transformation and the objectives of service integration. These efforts should focus, among other things, on the deployment of organizational, clinical, human, and material resources to support practice renewal and continuing education for nurses to prepare them for the requirements of integration. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0720-8) contains supplementary material, which is available to authorized users. BioMed Central 2015-03-03 /pmc/articles/PMC4359500/ /pubmed/25884845 http://dx.doi.org/10.1186/s12913-015-0720-8 Text en © Longpré and Dubois; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Longpré, Caroline
Dubois, Carl-Ardy
Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title_full Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title_fullStr Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title_full_unstemmed Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title_short Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
title_sort implementation of integrated services networks in quebec and nursing practice transformation: convergence or divergence?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359500/
https://www.ncbi.nlm.nih.gov/pubmed/25884845
http://dx.doi.org/10.1186/s12913-015-0720-8
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