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Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol
BACKGROUND: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983016/ https://www.ncbi.nlm.nih.gov/pubmed/27519520 http://dx.doi.org/10.1186/s12913-016-1626-9 |
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author | Bracco, Mario Maia Mafra, Ana Carolina Cintra Nunes Abdo, Alexandre Hannud Colugnati, Fernando Antonio Basile Dalla, Marcello Dala Bernardina Demarzo, Marcelo Marcos Piva Abrahamsohn, Ises Rodrigues, Aline Pacífico Delgado, Ana Violeta Ferreira de Almeida dos Prazeres, Glauber Alves Teixeira, José Carlos Possa, Silvio |
author_facet | Bracco, Mario Maia Mafra, Ana Carolina Cintra Nunes Abdo, Alexandre Hannud Colugnati, Fernando Antonio Basile Dalla, Marcello Dala Bernardina Demarzo, Marcelo Marcos Piva Abrahamsohn, Ises Rodrigues, Aline Pacífico Delgado, Ana Violeta Ferreira de Almeida dos Prazeres, Glauber Alves Teixeira, José Carlos Possa, Silvio |
author_sort | Bracco, Mario Maia |
collection | PubMed |
description | BACKGROUND: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients’ outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients’ care and outcomes. METHODS/DESIGN: A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients’ medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients’ 30-day hospital readmission rates. A sample size of 560 patients was calculated to fit a valid logistic model. In addition, qualitative approaches will be used to identify subjective perceptions of providers about the implementation process and of patients about health system use. DISCUSSION: This research project will gather relevant information about implementation processes for education and communication tools and their impact on human resources training, rates of readmission, and patient-related outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1626-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4983016 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49830162016-08-14 Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol Bracco, Mario Maia Mafra, Ana Carolina Cintra Nunes Abdo, Alexandre Hannud Colugnati, Fernando Antonio Basile Dalla, Marcello Dala Bernardina Demarzo, Marcelo Marcos Piva Abrahamsohn, Ises Rodrigues, Aline Pacífico Delgado, Ana Violeta Ferreira de Almeida dos Prazeres, Glauber Alves Teixeira, José Carlos Possa, Silvio BMC Health Serv Res Study Protocol BACKGROUND: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients’ outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients’ care and outcomes. METHODS/DESIGN: A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients’ medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients’ 30-day hospital readmission rates. A sample size of 560 patients was calculated to fit a valid logistic model. In addition, qualitative approaches will be used to identify subjective perceptions of providers about the implementation process and of patients about health system use. DISCUSSION: This research project will gather relevant information about implementation processes for education and communication tools and their impact on human resources training, rates of readmission, and patient-related outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1626-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-08-12 /pmc/articles/PMC4983016/ /pubmed/27519520 http://dx.doi.org/10.1186/s12913-016-1626-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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 | Study Protocol Bracco, Mario Maia Mafra, Ana Carolina Cintra Nunes Abdo, Alexandre Hannud Colugnati, Fernando Antonio Basile Dalla, Marcello Dala Bernardina Demarzo, Marcelo Marcos Piva Abrahamsohn, Ises Rodrigues, Aline Pacífico Delgado, Ana Violeta Ferreira de Almeida dos Prazeres, Glauber Alves Teixeira, José Carlos Possa, Silvio Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title | Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title_full | Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title_fullStr | Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title_full_unstemmed | Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title_short | Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol |
title_sort | implementation of integration strategies between primary care units and a regional general hospital in brazil to update and connect health care professionals: a quasi-experimental study protocol |
topic | Study Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983016/ https://www.ncbi.nlm.nih.gov/pubmed/27519520 http://dx.doi.org/10.1186/s12913-016-1626-9 |
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