bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing Collaborative Mental Health Care in Canada’s Primary Care Settings: A National Quality Framework with Recommended Measures
Authors: Ta Uyen 
Published: January 2024

Collaborative mental health care involves primary care providers and mental health specialists working together in structured ways to improve access to care, quality of care and outcomes. Collaborative mental health care is a proven approach to improve timely access to evidence-informed care, individual health outcomes, patient experience of care, equitable health care delivery and outcomes across populations, and cost-effectiveness of care. However, its implementation in Canadian primary care settings is variable and do not necessarily align with research evidence. This has led to a knowledge-to-practice gap regarding the comparative effectiveness of the different collaborative mental health care practices that teams and organizations may use to achieve desired outcomes. The Mental Health Commission of Canada (MHCC) and its partners are pleased to share a pan-Canadian evidence-based framework for planning and measuring quality collaborative care. The report, “Advancing Collaborative Mental Health Care in Canada’s Primary Care Settings: A National Quality Framework with Recommended Measures” is the result of a two-year project led by the Quality Improvement for Collaborative Care (QI4CC) research team and is based on extensive consultations with providers, planners, and people with lived experience. A qualitative study was used to explore the current state of collaborative care across Canada and determine how to define and measure its quality and the project team engaged a multi-stakeholder group throughout the entire project to get feedback on the research process and findings and to refine and finalize the framework. The resulting revised Quality Improvement for Collaborative Care (QI4CC) framework was developed to assist stakeholders in organizing and delivering primary care mental health and addictions services. The framework is intended to help leaders in practice and policy put in place needed supports and structures to achieve successful implementation of good practices in collaborative care as well as recommending quality measures to prioritize when evaluating collaborative care initiatives in primary care practices.
Learning Objectives:
1. Have a better understanding of collaborative mental health care in primary care settings
2. Provide an overview of the Quality Improvement for Collaborative Care framework and the key components in delivery of effective collaborative mental health care
3. Identify recommended measures to evaluate and improve the quality of collaborative care in primary health settings
4. Explore opportunities to apply the QI4CC framework for an international audience
Target Audience: health-care providers – especially those involved in delivering mental health care in primary care settings, administrative leaders of health services, policymakers, and champions of collaborative care in mental health and addictions services (includes people with lived and living experience)
Factors associated with the extent of nurses’ involvement in promotion of the nursing profession: A study among nurses working in diverse healthcare settings.
Authors: Rozani Violetta , Kagan Ilya 
Published: January 2024

Aims and objectives: To examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings.
Background: Little is known about the factors that contribute to nurses’ involvement in the promotion of the nursing profession.
Methods: The study population comprises a convenience sample of registered nurses (n=526) with ≥3 months’ experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards, or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses' involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were performed.
Results: Nurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses' involvement in promotion of the nursing profession. In contrast, holding a master’s degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession.
Conclusion: The extent of nurses' involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment.
Clinical Relevance: Healthcare managers may advance nurses’ involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse’s role.
Understanding inpatient acuity grading in hospitalised patients in an integrated care model
Authors: Bundele Anjali , Mukhopadhyay Amartya , Sumner Jennifer , Hong Wei Zhen 
Published: January 2024

Background: An integrated care model was introduced at Alexandra hospital in 2018. A key feature of the model is the acuity grading system, wherein admitted patients are assigned to either L3(Acute), L2(subacute) and L1(non-acute and rehabilitation). Currently, acuity-grade is assigned based solely on the clinical judgement of the attending clinicians. The assigned acuity determines the frequency of parameter-monitoring and clinician contact time. The acuity level is evaluated daily and reassigned when indicated.
Aim: To examine the consistency of acuity-grading in various clinical scenarios and explore the factors considered while assigning acuity.
Methods: We adopted a mixed-method approach. Physicians(n=66) from all medical specialities were surveyed on their decision making skills based on ten hypothetical scenarios. The data were used to determine agreement between physicians on their assessment of the severity and acuity-grade assignment. Subsequently, focus group discussions are planned with clinicians to understand what factors influence their decisions, and how do they rank each of these factors in terms of value in determining acuity.
Results: The survey demonstrated good agreement among clinicians on assigning acuity-grades to the clinical scenarios presented to them. But understanding the factors that should be taken into consideration while acuity is decided is crucial for the success of the model of care. We aim to achieve this through the focus group discussions that will commence in the immediate future.
Conclusions: A clear understanding of factors and criteria that currently constitute a clinician’s “gut sense/clinical acumen” is essential to ensure the right acuity-assignment and the corresponding care of the hospitalized patients. This will enable optimum allocation and utilisation of resources.
Ageing well in place: EET as an answer to the need for integrated care and support
Authors: Dierckx Eva , Lauwereys Katrien , Haekens An , Abrahams Katrijn , Beyen Anne 
Published: January 2024

Background: Older people prefer to stay as long as possible in their own home and environment. However, as people age, they are typically confronted with age-related declines on different domains; often leading to multidimensional (physical, psychological, social and environmental) frailty, which is associated with an increased vulnerability to adverse health outcomes and a decrease in wellbeing. In order to age well at home, one must shift from the (often) current fragmented, supply-driven support to a more integrated and multidisciplinary demand-driven support that focuses on the wants and needs of older people and their caregivers.
The Elder Expertise Team in Tienen (Belgium): Currently, as also mentioned by our stakeholders of informal caregivers, there is insufficient continuity and coherence between the different disciplines involved in the support and care at various echelons. This often leads to non-transparency, not only for older frail people but also for their informal and formal caregivers. As a result, the problems are not recognized, nor treated in time, leading to a threatening of the autonomy, participation in society, health and wellbeing and often leading to an admission into a residential care facility.
To address this need, in Tienen, the “Elderly Expertise Team (EET)” was established in 2019 with the objective of enabling frail elderly people to live at home for as long and as qualitatively as possible by offering the most appropriate care and support. The EET has a multidisciplinary, cross-sector and cross-organizational composition, using a network-oriented approach. In order to give an answer to multidimensional frailty, besides healthcare partners also partners from welfare are part of the EET.
The EET serves as a “single point of entry” which coordinates care and support across a network of different care and support providers. The EET uses a stepped-care approach: (1) one starts with giving (general) advice by phone, (2) if there is a need for additional case-specific support an assessment and/or screening is done, leading to case-specific tailored advice and a short-term treatment of up to 5 sessions is provided; (3) if necessary, a referral to more specialized care is done. Besides the care for older persons and their caregivers, the EET also provides coaching, trainings and intervisions for formal caregivers. This all results in better and integrated care and support, leading to reduced admissions to residential care and a better wellbeing for the older person and his/her context.
Future: Currently, the EET works mainly at the intervention level. However, in the future a more population-based approach using risk-profiles for multidimensional frailty and doing pro-active home visits might also lead to a better casefinding and prevention of frailty. Moreover, as the focus is now on clinical and service integration, the EET recognizes the need for functional integration by means of shared electronic patient records.
Coaching Leadership in Small Scale Normalized Living
Authors: Proost Antje , Robberechts Griet 
Published: January 2024

Our human resources policy not only seeks to anticipate current developments but also wishes to play a pioneering role. This starts with a strong vision in which employees are partners in the organization of care and not mere suppliers of care. Where giving and taking responsibility, open communication and autonomy in connection are realized (and not hollow concepts). This also means that we are a flat organization where there are few or no hierarchical structures. The demand from employees for more collaboration, a different model of leadership, the convergence of responsibilities and authority was a clear message for us to tackle the organization thoroughly. A good organization is crucial for a company to function well. This includes having competent employees, sufficient finances and adequate equipment.
Innovative labor organization
According to the IAO (Innovative Labor Organization) method, we want to examine in each of the four residential care centers how we can come to a team that has sufficient regulatory capacity to

work autonomously with responsible employees;
ensure the quality care that we use in our vision;
have sufficient manageability and flexibility for this;
create more innovative capacity;
with sufficient participation;
in mutual cooperation.

Step by step we discovered that the IAO fits seamlessly with the operating principles of Small Scale Normalized Living. From our strong belief in the power of the capacities and competencies of employees and the continuous will to invest in employees, the step to this new organizational model is a logical next step. An obvious choice that also led to confrontations: how do we distribute tasks and responsibilities in the organization today? Do we really give employees the necessary autonomy that they need? Do we let employees shine sufficiently in all their potential? Do we involve them in those processes in which they need to be involved? Which sub-processes run centrally or decentralized?
With a critical eye and the constant desire to improve, we laid the foundation for the care model of the future.
Social and Psychological Long-Term Consequences of NMDA Receptor Encephalitis (SAPIENCE) - from patients’ views to patient-centred care
Authors: Kurpas Donata , Duda-sikuła Marta , Finke Carsten , Dalmau Josep , Honnorat Jérôme , Heine Josephine , Mendes Álvaro , Howard Fuchsia 
Published: January 2024

Background and target population: NMDA receptor encephalitis is a rare autoimmune disease with severe neurological and neuropsychiatric symptoms but typically a good functional neurological outcome. Nevertheless, most patients suffer long-term cognitive, psychological, and social impairments that have a significant impact on their well-being and occupational or educational activities-this is of particular concern given the young age of patients (median 21 years). However, because the disease was only recently discovered (2007), these psychosocial effects have not been systematically studied and the resulting impact on patients is not adequately appreciated. The SAPIENCE study is an international scientific project funded by the European Joint Program that aims to characterize the long-term cognitive and psychosocial consequences of this rare disease. The leader of the consortium is Prof. Carsten Finke, Charite Berlin. The Polish team, coordinated by Prof. Donata Kurpas, is responsible for the development of standard protocols, monitoring and training of staff in the study centers where the data are collected, and the corresponding qualitative data analysis.
Study Design/Methods: Patients will be extensively studied at three European study sites in three consecutive project levels. Stage 1 includes in-depth on-site interviews and focus groups (n=30). Stage 2 develops a semi-structured short-form interview and includes on-site neuropsychological testing (n=150). Stage 3 includes an international online survey of patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), and disease progression information (n=300). Stages 1-3 will support each other in developing structured interviews, survey questions, and treatment guidelines.
Results/Outcomes: At Level 1, we will identify themes and narratives that influence patients' quality of life and their experience of coping with the disease. At Level 2, we will identify neuropsychological outcomes in the largest cohort of NMDAR encephalitis patients in the world to date, including executive function, memory, and spatial navigation performance, which have been identified as key areas of impairment. At Level 3, we will examine subjective outcomes and individual predictors of post-acute disease progression.
Based on Stages 1-3, we will develop international consensus guidelines for post-acute care of NMDARE patients.
Impact: This project is the first to bridge the gap between standardized assessment and individual patient experience in the long-term follow-up of patients with autoimmune encephalitis. By incorporating the patient perspective into medical decision-making, current and future NMDAR encephalitis patients will benefit from the implementation of the diagnostic and treatment guidelines developed in this project for patient-centered post-acut
Therapeutic impact of an intervention associating pharmacist counseling and the use of a mobile health application for type 2 diabetes patients
Authors: Attipoe Alfred , Santi Anne , Verrue Charlotte , Delhaye Nicolas , Willaert Marine , Tomas Marc , Philippe Geneviève 
Published: January 2024

Background and objectives: Diabetes represents a real public health problem, due to its constantly increasing prevalence and many complications. Prevalence of type 2 diabetes is high in Belgium (estimated at over 8%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of health-promoting behaviors, complemented if necessary by drug treatment, prevents complications, improves the patient's quality of life, and reduces mortality. It is essential to implement multidisciplinary patient support, in which the pharmacist can participate through pharmaceutical care, but also through the implementation of educational sessions promoting the involvement of the diabetic patient in the management of his or her health. Research suggests that the use of mobile technologies combined with health coaching can help patients with their daily life and disease management. This study, a collaboration between ULiège, Multipharma and Comunicare, aims at exploring the benefits of the use of mobile technologies combined with health coaching by the community pharmacist for type 2 diabetes patients. The intervention aimed to reinforce the patient's willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of therapeutic adherence.
Intervention and methods: This interventional study combined educational intervention and coaching sessions by the community pharmacist with the daily use of a mobile health application provided by Comunicare. This was a quantitative study established over a period of six months with three data collection periods (before, during and after the intervention). Primary outcomes (HbA1c and MARS-5 score), related to the level of medication adherence, and secondary outcomes (HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, BMI and waist circumference), considered as cardiovascular risk factors, were analyzed.
Results: The baseline sample consisted of 66 patients, 50 of whom completed the study. Statistical analyses did not show an improvement in the level of medication adherence. However, significant results were observed for systolic blood pressure and waist circumference (both improving). All the other outcomes, including HbA1c, changed positively or stabilized between the beginning and end of the study.
Conclusion: This study showed that counseling by the community pharmacist, combined with the use of a mobile health application, can achieve the therapeutic intent of physician-initiated therapy and have a positive impact on the management of the type 2 diabetic patients as well as on outcomes considered as cardiovascular risk factors.
Innovating Health Governance in Australian Integrated Care
Authors: De Souza Alexandra , Schneider Carmen Huckel , Schierhout Gill , Peiris David 
Published: January 2024

Background: Australia is one of many countries implementing integrated care initiatives to facilitate the Quadruple Aim (the improvement of health outcomes, patient experience, provider experience and health system sustainability). These initiatives can be complex while working within a fragmented and siloed health system. NSW Health has created the Patient Centred Collaborative Commissioning Groups (PCCGs) program facilitating Local Health Districts (LHDs) and Primary Health Networks (PHNs) to co-commission health initiatives targeting local populations and their specific health needs. These PCCGs are unique as they are comprised of stakeholders involved at all levels of government in addition those from the community and private sectors. The LHDs and PNHs collaborate with additional relevant and local stakeholders to co-design new service pathways and ensure collaboration within one local health system.
The literature evaluating integrated care aims at advancing knowledge of patient and provider experiences. Both areas are vital to understanding the successes and failures of integrated care but are insufficient to understand the ‘how’ and ‘why’ of successful system integration. This study therefore focuses on the under-researched question of ‘is it possible to govern integrated care?’
In the Australian context, the governance of integrated care needs significant attention. In the context of this research, health system governance is defined as “the norms, structures, actors, institutions, and formal and informal relationships that shape authority and action in a health system”.
Methods: This qualitative study involves semi-structured interviews with key stakeholders involved in the PCCGs and reviewing the governance documents of each local program. Data collected is thematically analysed and compared to existing governance models to draw out aspects of the individual PCCG governance mechanisms. This is part of a larger study that aims to understand the stakeholders, partnerships, and governance in integrated care in Australia.
Implications for the future: This study will provide an in-depth understanding of the decision-making processes involved in the development (and subsequent use) of the governance models, as well as determining which actors have what roles and accountabilities within the PCCG. It is vital to determine what contributes to and facilitates each domain of health system governance (as defined above) to truly understand how we can achieve sustainable health care system reform. Traditional governance models are not sufficient to regulate the dynamic nature of integrated care initiatives, so they cannot facilitate the sustainability of these initiatives. As such, the overarching aim of this research is to create an ideal governance framework that can be replicated and applied across various integrated care initiatives.
Accuracy of THINK Center telephone triage in post-discharge patients: an observational study in real patients.
Authors: Chia Ching Yee , Ong Shu Fen , Huan Lydia Liu , Ashikin Biinte Shahri Nurul , Lee Ching Ching , Ang Yan Hoon , Tew Chee Wee 
Published: January 2024

Objective: Tele-health & Integrated Network (THINK) Centre is a telehealth centre which offers 24/7 urgent care hotline with telephone triage capabilities for post-discharge care and community support for patients discharged from Khoo Teck Puat Hospital (KTPH), Singapore. This study aims to assess the accuracy of THINK telephone triage in identifying the need for emergency care and also identify factors which affect triage accuracy.
Methods: A retrospective observational cohort study. 195 inbound calls to KTPH THINK Center teleservice between 1 January to 30 June 2022 were included. These calls were handled by THINK telephone triage nurses who were trained in THINK workflow and tele-triage protocols adapted for post discharge patients. Accuracy of triage disposition was assessed by matching the nurse telephone triage tier compared to the gold standard triage tier (a consensus by a panel of doctor and nurses after reviewing of medical records, triaging symptoms and health service utilization within 1 week of triage call).
Outcome: THINK telephone triage had an overall accuracy of 89.74%. With regards to identifying the need for emergency care, THINK telephone triage had an overall 90.00% sensitivity (95% CI: 80.48% to 95.88%) and 98.40% specificity (95% CI: 94.34% to 99.81%). Multivariable analysis suggested cardiovascular complains (OR 7.605, 95% CI 1.118 to 51.722) and telephone triage nurses having community nursing experience (OR 18.606, 95% CI 1.279 to 270.77) are positive predictors of accurate triage. Non-emergency triage disposition (OR 0.143 95% CI 0.024 to 0.838) was associated with inaccurate triage - predominantly under-triage.
Conclusion: This study shows that THINK telephone triage has a good accuracy rates of 89.74%. While this suggest that the current triage protocols used is safe and effective, refinement can be explored to enhance its accuracy of distinguishing non-emergency triage dispositions. The findings of this study will guide triaging quality improvement as well as future scaling and replication of the service.