Online multidisciplinary integrated rural healthcare education programs during the COVID-19 pandemic for students from different universities: Experiences and guidelines

Purpose: The COVID-19 pandemic has led to "forced innovation" in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities. Design/methodology/approach: A multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program. Findings: This case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines. Originality/value: The originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Training MSW Students for Integrated Behavioral Health Care During COVID-19: Lessons Learned from Two Programs

This article describes how two Southeastern social work programs delivered integrated behavioral healthcare training to MSW students and social work practitioners during the COVID-19 pandemic. COVID-19 posed challenges across five domains, including: (a) adaptations to course curricula;(b) adaptations to field education curricula;(c) experiences of grief, distress, and behavioral health issues by stakeholders;(d) organizational strain to universities and departments;and (e) effects on clients and the community. This article describes specific ways in which these two training programs were impacted in these five areas and modified in response, as well as similarities and differences experienced across institutions. Implications for these training programs, and social work education programs in general, are offered.

Primary care behavioral health in the time of COVID-19

People are commonly receiving mental health treatment from primary care providers rather than from behavioral health providers. To address this issue, the healthcare system has begun to integrate behavioral health providers into primary care clinics, known as integrated primary care (IPC). Research suggests that IPC can lead to a number of benefits, including increased likelihood of patients receiving the appropriate standard of care, as well as reduction in healthcare costs due to medical cost offset. While IPC is a promising method of healthcare delivery, additional research is needed to optimize this system. Additionally, the onset of the COVID-19 pandemic has drastically impacted the mental and physical health needs of the United States population, especially for low income and racial and ethnic minority populations. However, there is little research on how this has impacted the presenting problems seen in IPC, or how IPC utilization may have been impacted. This study will examine patient characteristics and IPC utilization of two clinics serving a low income and racial and ethnic minority population and assess how patient and provider characteristics are impacting the process of IPC. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

An emerging future for work and education: Implications for integrative learning in social work

Social work practice education should be designed for sustainability and relevance in emerging and future work contexts. Changes influencing the emerging world of work including transformations in services, communication technologies, distributed working patterns, and new priorities and identities should inform the design of the integrated learning components of the curriculum. Changes influencing the future delivery of education include increased demand for flexible, collaborative, networked and digital learning;pre-existing but rapidly accelerated because of COVID-19. Together, these drivers compel us to innovate to ensure graduates are practice ready and resilient in these evolving contexts. In this analysis of social work, nursing, and allied health literature diverse approaches to integrative learning are examined, generating an evidence base for informing decision making when innovating in the design of integrative learning. This article advocates an orientation towards the future world of work and education, as a lens for reimagining integrative learning in social work. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The SECURE STAIRS framework: preliminary evaluation of the impact on therapeutic climate in a secure children's home (SCH)

PurposeThe SECURE STAIRS framework for integrated care is a trauma-informed approach to supporting staff and young people within the Children and Young People's Secure Estate (CYPSE) in the UK. Within secure settings, therapeutic climate is a concept that encapsulates an individual's perception of safety, connectedness with others and level of support within the environment. To support evaluation of the SECURE STAIRS framework, a Secure Children's Home (SCH) within the North East of England examined therapeutic climate for staff and young people annually using the Essen Climate Evaluation Schema (EssenCES) over a three-year period. This paper aims to present the findings.Design/methodology/approachOver the three years, a total of 71 young people and 214 staff EssenCES questionnaires were administered. Between 2020 and 2021, the setting also experienced significant changes resulting from the COVID-19 pandemic. Numbers of young people also decreased within the setting over the three-year period.FindingsResults indicated a positive trend for therapeutic climate sub-scores. For example, Experienced Safety for young people significantly increased from 2020 to 2021. Additionally, therapeutic hold for staff was significantly higher in 2020 and 2021 in comparison to 2018.Originality/valueFindings are discussed in relation to implementation of the SECURE STAIRS framework and providing trauma-informed care for vulnerable young people within secure settings. Implications for practice are explored.

Integrated Health Care during the COVID-19 Pandemic: A Social Justice View from the Perspectives of Social Workers

COVID-19 has laid bare the enormous health disparities that still exist in the United States due to racial injustice. Due to these disparities, nondominant racial and ethnic groups have experienced disproportionate rates of infection and death from COVID-19. Social justice is a cardinal value of the social work profession. In response to the COVID-19 pandemic, social workers need to play a role in addressing the health disparities that exist in the United States. This qualitative study examined the perspectives of forty social workers who worked as individuals in integrated healthcare settings during the COVID-19 pandemic. Participants indicated that structural racism was a primary factor that contributed to health disparities during the COVID-19 pandemic.

Mobile health and the social organization of care in the global south: Beyond technological fixes

The notion of a global "care crisis" has recently loomed large in public consciousness, drawing attention to the longstanding problem of how our care infrastructures are increasingly overburdened and unsupported. The chronic under-investment in paid and unpaid healthcare work has been made especially clear in light of the shocks of the COVID-19 pandemic. In response to this crisis, transnational agencies, national governments, hospitals, and non-governmental organizations (NGOs) have sought to leverage increasing smartphone and mobile internet use globally to create "technological fixes" that restructure work, time, and space with the aim of meeting care needs with limited resources-this in contrast to investments that could increase resources but ultimately compromise on capitalistic aims of profit and efficiency. In this dissertation, I examine multiple types of fixes that have gotten significant traction in global health, including digital payments, personal chat apps, and semi-automated chatbots, focusing on contexts within India and Kenya. I describe care workers' and health organizations' experiences with these technologies and how they integrate with larger health infrastructures. Drawing on feminist social reproduction theory, I tease out ways that these technologies meet real and urgent care needs, while also belying the mere redistribution, short-term valuation, and narrowing of care work that takes place by and through technological fixes (often most affecting those with the least power in a given context). Taking this dilemma seriously, I argue for the responsibility of researchers and practitioners to combat dominant narratives of technological fixes for the care crisis, even as we seek to support care work through design. Thus, this work considers how we might center futures of care work in which societies make concrete investments in care workers and care infrastructures, not for efficiency's sake but for the needs and aspirations of care workers and the sustainability of our care infrastructures. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Crisis and mental health of working women: risk factors and integrated care interventions based on organizational, individual, and institutional partnership: Managing Community Care

Purpose>Crises can weigh heavily on individuals' mental health. COVID-19 is a crisis that has shaken humanity, plunging it into a great wave of fear, ambiguity and uncertainty, due to its novelty and rapid spread, as well as lethality. Mental health disparities between women and men have widened as a result of this pandemic. Stress factors have multiplied, especially among working women, making them more psychologically vulnerable than they were before this pandemic and easy prey to psychological distress. This emphasized the importance of having integrated care interventions that take into consideration the organizational context, with gendered lenses. This paper discusses the relationship between COVID-19 and psychological distress among women in the workforce. It presents the main sources of stress and addresses integrated care interventions that can help to prevent psychological distress among women.Design/methodology/approach>This paper is a viewpoint and critique of the recent literature.Findings>Interventions based on a partnership between employers, employees, and government, including health and social services are needed to prevent mental health problems among women in the workplace that can result from crises. In this case, a gendered approach as well as an optimization of the use of new technologies should be favored.Originality/value>There is little focus on the development of integrated care approaches to address psychological distress among working women in times of crisis and beyond. This paper helps to expand the scope of integrated care to work-related mental health research by exploring the impact of an unprecedented health crisis on a vulnerable group that suffers from disparities in mental health. It also provides insights into preventive interventions, built upon an integrated care approach, based on a tripartite partnership between working women, employing organizations, and governmental institutions, facilitated by the integration of new technologies. By doing this, the author aims to contribute to the prevention of mental health issues that can result from this crisis.

Collaborer en contexte de COVID-19: Point de vue d'intervenants oeuvrant auprès de personnes judiciarisées sur les obstacles qu'ils ont rencontrés

Cet article se penche sur les réponses de 81 intervenants québécois oeuvrant auprès de personnes judiciarisées âgées de 16 à 35 ans à propos des défis que pose la crise sanitaire en matière de collaboration intra et interorganisationnelle. Ces intervenants, affiliés à diverses agences des milieux institutionnels et communautaires, ont rempli, entre novembre 2020 et juin 2021, un questionnaire portant notamment sur les effets de la crise pandémique sur leur capacité à travailler en collaboration. Les résultats de cette enquête montrent comment les conséquences de cette crise sont venues affecter la dimension organisationnelle de la collaboration intra et interorganisationnelle et encore davantage, sa dimension interactionnelle. En d'autres mots, ces résultats révèlent combien les relations humaines constituent un élément fondamental à la collaboration, tant celles que les intervenants développent entre eux que celles qu'ils développent avec leur clientèle. Au final, cet article porte à réfléchir sur les conditions essentielles à la collaboration ainsi que sur les attentes que l'on fait peser sur elle en faveur d'une meilleure intégration des services et d'un accompagnement mieux adapté à la complexité des trajectoires des personnes judiciarisées.Alternate :This article examines the responses of 81 Quebec practitioners working with criminalized individuals aged 16 to 35 who were surveyed about the challenges posed by the pandemic crisis in terms of intra- and inter-organizational collaboration. These practitioners, affiliated to various public and community agencies, completed, between November 2020 and June 2021, a questionnaire regarding the impact of COVID-19 on their ability to work in collaboration with other practitioners. The findings of this study show that the crisis has had particularly powerful effects on the organizational dimension of collaboration, and even more so on the interactional dimension of collaboration. More specifically, the findings indicate how human relationships constitute an essential aspect of collaborative practices, regarding both collaboration among practitioners and collaboration with clients. In conclusion, this article provides an opportunity to reflect on the conditions essential for collaborative work between practitioners, as well as on the expectations one should have with regard to the integration of services and the support of criminalized individuals.Alternate :Este artículo examina las respuestas de 81 trabajadores quebequenses que trabajan con personas judicializadas de entre 16 y 35 años sobre los retos que plantea la crisis sanitaria en términos de colaboración intra e interinstitucional. Entre noviembre de 2020 y junio de 2021, estos trabajadores, afiliados a diversos organismos institucionales y comunitarios, completaron un cuestionario sobre los efectos de la pandemia en su capacidad para trabajar juntos. Los resultados de esta investigación muestran cómo las consecuencias de esta crisis han afectado a la dimensión organizativa de la colaboración intra e interorganizativa y, sobre todo, a su dimensión interactiva. En otras palabras, estos resultados muestran cómo las relaciones humanas son un elemento fundamental de la colaboración, tanto las que los profesionales desarrollan entre sí como las que desarrollan con sus usuarios. Finalmente, este artículo reflexiona sobre las condiciones esenciales para la colaboración, así como sobre las expectativas que se depositan en ella en favor de una mejor integración de los servicios y de un apoyo mejor adaptado a la complejidad de las trayectorias de las personas judicializadas.

A co-production approach to exploring an integrated service model in UK local authorities

PurposeIntegrated service models aim to simplify access, enable effective delivery, remove duplication and provide a holistic and person-centred approach. This project explored the development of integrated well-being services in two local authorities in North-East England. The purpose of this paper is to address this issue.Design/methodology/approachUnderpinned by public health and co-production approaches, the project utilised a mixed-methods approach. Data were collected via online surveys (n = 95), virtual interviews with members of the local population (n = 8) and practitioners and commissioners (n = 8) to explore needs for a new service. Thematic analysis was used to identify key themes and issues.FindingsSeveral benefits of an integrated service were highlighted by both staff and service users, with a central anticipated benefit being the provision of holistic care. Improvement in information sharing was also seen to increase the efficiency of services and communication barriers between services. Beneficial aspects and barriers related to the COVID-19 pandemic on current service provision were reported that have informed our future recommendations.Originality/valueThe authors' findings provide a much deeper insight into function, care, social inclusion and ongoing support needs, from both the perspectives of staff and service users. Service users and staff saw value in an integrated model for themselves, as well as the wider community. The authors' findings indicate that the integrated service model is a promising one for the development of services within local authorities.

Aging all over the place: a multidisciplinary framework that considers place and life trajectories of older adults within their communities

Purpose>This conceptual paper aims to describe aging all over the place (AAOP), a federative framework for action, research and policy that considers older adults’ diverse experiences of place and life trajectories, along with person-centered care.Design/methodology/approach>The framework was developed through group discussions, followed by an appraisal of aging models and validation during workshops with experts, including older adults.Findings>Every residential setting and location where older adults go should be considered a “place,” flexible and adaptable enough so that aging in place becomes aging all over the place. Health-care professionals, policymakers and researchers are encouraged to collaborate around four axes: biopsychosocial health and empowerment;welcoming, caring, mobilized and supportive community;spatiotemporal life and care trajectories;and out-of-home care and services. When consulted, a Seniors Committee showed appreciation for flexible person-centered care, recognition of life transitions and care trajectories and meaningfulness of the name.Social implications>Population aging and the pandemic call for intersectoral actions and for stakeholders beyond health care to act as community leaders. AAOP provides opportunities to connect environmental determinants of health and person-centered care.Originality/value>Building on the introduction of an ecological experience of aging, AAOP broadens the concept of care as well as the political and research agenda by greater integration of community and clinical actions. AAOP also endeavors to avoid patronizing older adults and to engage society in strengthening circles of benevolence surrounding older adults, regardless of their residential setting. AAOP’s applicability is evidenced by existing projects that share its approach.

The European Health Data Space: a step towards digital and integrated care systems: Managing Community Care

Purpose>The COVID-19 pandemic has demonstrated the urgency of better chronic disease management and the importance of making it an integral part of the recovery agenda in Europe. This paper aims to explore the shift towards digital and integrated care systems in Europe.Design/methodology/approach>In this viewpoint paper the Expert Group for Integrated Care and Digital Health Europe (EGIDE) group argues that an orchestrated shift towards integrated care holds the solution to the chronic disease pandemic.Findings>The development of integrated care cannot happen without shifting towards a digitalised healthcare system via large-scale initiatives like the European Health Data Space (EHDS) and the involvement of all stakeholders.Originality/value>The EGIDE group has identified some foundational principles, which can guide the way to realise the full potential of the EHDS for integrated care and can support the involved stakeholders’ thinking.

Guest editorial: Advancing integrated care with digital health innovation issue editorial: Managing Community Care

The proposed framework, being applied in Finland, acts as a set of standards to format data to allow it to move from one place to another (known as the “middle layer” in interoperable systems) bringing together different data elements to support a Virtual Care Operator model – an “information-focused approach to integration, coordination and continuity of care.” Domains in this model focus on technology, team organization, program support, integration of information systems, performance and quality, with maturity assessed on how well the model is enabling integration of service delivery around coordination of activities and other key issues like equity. Aird and colleagues present an implementation focused evaluation, using a multi-method approach to explore the roles and use of a new system of information exchange between one hospital and one long-term care home in Canada. Stamenova et al. evaluate a virtual visit program put in place to provide access to care during the COVID-19 pandemic using a convergent mixed-methods design which draws on usage data, surveys and interviews with patients and provider users of virtual care systems across different units within a hospital.

A maturity model framework for integrated virtual care: Managing Community Care

Purpose>Remote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies contribute to integrated care. Since maturity models are useful frameworks for understanding current performance and motivating progress, the authors developed a model describing the features of RPM that can advance integrated care.Design/methodology/approach>This work was led by St. Joseph's Health System Centre for Integrated Care in collaboration with clinical and programme leads and frontline staff offering RPM services as part of Connected Health Hamilton in Ontario, Canada. Development of the maturity model was informed by a review of existing telehealth maturity models, online stakeholder meetings, and online interviews with clinical leads, programme leads, and staff.Findings>The maturity model comprises 4 maturity levels and 17 sub-domains organised into 5 domains: Technology, Team Organisation, Programme Support, Integrated Information Systems, and Performance and Quality. An implementation pillars checklist identifies additional considerations for sustaining programmes at any maturity level. Finally, the authors apply one of Connected Health Hamilton's RPM programmes to the Team Organisation domain as an example of the maturity model in action.Originality/value>This work extends previous telehealth maturity models by focussing on the arrangement of resources, teams, and processes needed to support the delivery of integrated care. Although the model is inspired by local programmes, the model is highly transferable to other RPM programmes.

Integrated care with digital health innovation: pressing challenges: Managing Community Care

Purpose>Digital health care has emerged as one of the most important means to deliver integrated care by care providers in recent years. As the use of digital health increases, there are some pressing issues such as interoperability of data across different healthcare information systems, regulatory environment and security and privacy of patient’s information which need to be discussed and addressed in order to reduce information silos and to ensure efficient and seamless use of digital health technologies. The purpose of this paper is to address these issues.Design/methodology/approach>In this paper the authors outline the key concepts of interoperability, key challenges pertaining in achieving interoperability and concepts of security and privacy in context of digital health models of integrated care.Findings>The study suggests that standardization of digital health information systems and connecting existing systems to health network, addressing privacy and security related issues through a comprehensive but supportive regulatory environment and educating citizens and healthcare providers are some of the ways to achieve effective use of digital health in models of integrated care.Originality/value>Although the concepts of privacy and interoperability are not new, however, as per best of the authors’ knowledge, this is the first attempt to discuss the challenges and possible actions to meet the objective of achieving integrated care through digital innovation.

Providing long‐term care: Options for a better workforce

Older people and their care workers have been disproportionately affected by the COVID‐19 pandemic. Many OECD Member countries have taken measures to contain the spread of the infection and improve the care workforce. Yet the health crisis is highlighting and exacerbating pre‐existing structural problems in the long‐term care (LTC) sector. In many OECD Member countries, recruiting enough workers in LTC remains a challenge and care workers experience difficult working conditions. Skills mismatch and poor integration with the rest of health care lie at the root of preventable hospital admissions even in normal times. Such challenges are likely to become ever more acute if no further action is taken given the speed of population ageing. Policies to improve recruitment and which also address retention through training, improvements in coordination and productivity, leveraging the effect of digital technologies, are needed.Alternate :Les personnes âgées et leurs soignants ont été touchés de manière disproportionnée par la pandémie de COVID‑19. De nombreux pays de l’OCDE ont pris des mesures pour empêcher la propagation de l’infection et augmenter le nombre de soignants. Néanmoins la crise sanitaire met en lumière et exacerbe les problèmes structuraux existants dans le secteur des soins de longue durée. Dans de nombreux pays membres de l’OCDE, le recrutement d’un nombre de travailleurs suffisants dans le domaine des soins de longue durée demeure un défi et les soignants ont des conditions de travail difficiles. L’inadéquation des compétences et une mauvaise intégration avec le reste des soins de santé donnent lieu à des hospitalisations évitables, même en temps normal. Compte tenu de la vitesse à laquelle la population vieillit, ces défis sont susceptibles de s’accentuer encore plus si aucune autre action n’est entreprise. Il est nécessaire de mettre en œuvre des politiques visant à améliorer le recrutement et permettant de maintenir les effectifs via la formation, des améliorations dans la coordination et la productivité, tout en tirant parti de l’effet des technologies numériques.Alternate :La pandemia de COVID‐19 ha afectado de forma desproporcionada a las personas de la tercera edad y sus proveedores de cuidados. Muchos países miembros de la Organización de Cooperación y Desarrollo Económicos (OCDE) han adoptado medidas encaminadas a evitar que la infección se propague y aumentar el número de proveedores de cuidados. A pesar de ello, la crisis sanitaria está poniendo de relieve y agravando los problemas estructurales existentes en el sector de los cuidados de larga duración. En muchos países miembros de la OCDE, la contratación de un número suficiente de proveedores de cuidados de larga duración sigue constituyendo un desafío y las condiciones de trabajo de dichos proveedores son complejas. Incluso en circunstancias normales, se registran hospitalizaciones evitables debido a competencias inadecuadas y a la escasa integración con el resto del sistema de atención de salud. Habida cuenta de la velocidad a la que envejece la población, es probable que estos problemas se agraven si no se adoptan medidas al respecto. Se precisan políticas que tengan por objetivo mejorar la contratación y abordar la retención mediante programas de formación, mejoras en materia de coordinación y de productividad, e iniciativas de aprovechamiento de las tecnologías digitales.Alternate :Ältere Menschen und ihre Pflegekräfte sind von der COVID‐19‐Pandemie unverhältnismäßig stark betroffen worden. Viele OECD‐Mitgliedstaaten haben Maßnahmen ergriffen, um die Ausbreitung der Infektion einzudämmen und das Pflegepersonal zu fördern. Die Gesundheitskrise verdeutlicht und verschärft jedoch bereits bestehende strukturelle Probleme im Langzeitpflegebereich. In vielen OECD‐Mitgliedstaaten ist es nach wie vor eine Herausforderung, genügend Arbeitskräfte für die Langzeitpflege zu finden, und die Arbeitsbedingungen für Pflegekräfte si d schwierig. Ein Qualifikationsdefizit und eine unzureichende Einbindung in die übrige Gesundheitsversorgung sind die Ursache für vermeidbare Krankenhauseinweisungen selbst in normalen Zeiten. Diese Herausforderungen werden wahrscheinlich immer akuter werden, wenn angesichts der raschen Alterung der Bevölkerung keine weiteren Maßnahmen ergriffen werden. Es bedarf Strategien zur Verbesserung der Personalrekrutierung und der Personalbindung durch Fortbildung, Verbesserung der Koordinierung und der Produktivität unter Nutzung der Wirkung digitaler Technologien.Alternate :Пандемия COVID‑19 оказала неравнозначное влияние на пожилых людей и персонал по уходу за ними. Многие страны‐члены ОЭСР принимают меры, чтобы контролировать распространение инфекции и улучшать качество рабочей силы в сфере ухода. Однако кризис в области здравоохранения выдвигает на первый план и усугубляет ранее существовавшие структурные проблемы в области долгосрочного ухода (ДУ). Во многих странах‐членах ОЭСР найм достаточного количества работников для ДУ остаётся проблемой, а сами работники в сфере ухода имеют тяжёлые условия труда. Даже и в обычные времена несоответствие навыков и плохое взаимодействие с остальными службами здравоохранения лежат в основе предотвратимых госпитализаций. Учитывая скорость старения населения, такие проблемы, вероятно, ещё сильнее обострятся, если в дальнейшем не будут приниматься соответствующие меры. Необходимы меры по улучшению ситуации с набором персонала, а также по удержанию работников посредством тренингов, улучшения координации работы и продуктивности, эффективного использования цифровых технологий.Alternate :老年人及其照护工作人员遭受了新冠肺炎大流行病不成比例的影响。许多经合组织成员国已采取措施控制感染传播并改善照护人员队伍。然而, 这场健康危机正凸显并加剧长期照护部门业已存在的结构性问题。在许多经合组织成员国, 招聘足够的长期照护工作人员仍然是一项挑战, 照护人员也面临着艰难的工作条件。即使在正常情况下,可避免入院问题的根源在于技能不匹配以及与其他卫生健康部门的整合不力。鉴于人口老龄化速度, 如不采取进一步行动, 这些挑战可能会变得更加严峻。需要制定政策来改善招聘, 并通过培训、改善协调和生产力以及利用数字技术成果来留住人才。Alternate :تأثر كبار السن والعاملين في مجال رعايتهم بشكل غير متناسب بجائحة كوفيد‐19. واتخذت العديد من البلدان الأعضاء في منظمة التعاون والتنمية في الميدان الاقتصادي ، لا يزال توظيف عدد كافٍ من العاملين في مجال الرعاية طويلة الأمد يمثل تحديًا ويواجه العاملون في المجال ذاته ظروف عمل صعبة. ويكمن عدم تطابق المهارات وضعف التكامل مع بقية جوانب الرعاية الصحية في أساسمنظمة التعاون والتنمية في الميدان الاقتصاديتدابير لاحت٠اء انتشار العدوى وتحسين القوى العاملة في مجال الرعاية. ومع ذلك، فإن الأزمة الصحية تسلط الضوء على المشاكل الهيكلية الموجودة مسبقًا وتؤدي إلى تفاقمها في قطاع الرعاية طويلة الأمد. وفي العديد من البلدان الأعضاء في الإستشفاءات التي يمكن الوقاية منها، حتى في الأوقات العادية. ومن المرجح أن تصبح مثل هذه التحديات أكثر حدة إذا لم يتم اتخاذ مزيد من الإجراءات بالنظر إلى سرعة شيخوخة السكان. وهناك حاجة إلى سياسات لتحسين التوظيف والتي تتناول الاستبقاء من خلال التدريب، وتحسين التنسيق والإنتاجية، والاستفادة من تأثير التكنولوجيات الرقمية.Alternate :Os idosos e seus profissionais de saúde foram desproporcionalmente afetados pela pandemia de Covid‐19. Muitos países membros da OCDE tomaram medidas para conter a propagação da infecção e melhorar a mão de obra assistencial. No entanto, a crise da saúde está destacando e agravando os problemas estruturais preexistentes no setor de cuidados de longa duração (LTC). Em muitos países membros da OCDE, o recrutamento de trabalhadores suficientes para LTC continua sendo um desafio e os profissionais de saúde vivenciam condições de trabalho difíceis. A incompatibilidade de competências e a integração deficiente com o restante dos cuidados de saúde estão na raiz das internações hospitalares evitáveis, até mesmo em tempos normais. Esses desafios provavelmente se tornarão cada vez mais intensos se nenhuma ação adicional for tomada, considerando‐se a velocidade do envelhecimento da população. Há necessidade de políticas para melhorar o recrutamento e que também abordem a retenção por meio de treinamento, melhorias na coordenação e na produtividade, aproveitando o efeito das tecnologias digitais.

Integrated primary mental health care in rural and remote contexts: The Australian experience

There is a growing burden of disease nationally and internationally from mental illness, both as a stand-alone problem and also comorbid with the growing epidemic of chronic, non-communicable diseases. The advent of the COVID-19 pandemic in early 2020 and ongoing climate change sequelae have exacerbated these mental health risks exponentially, creating massive service delivery dilemmas globally. In many countries, people in regional and particularly rural and remote areas, bear a greater disease burden from mental health conditions, due largely to the unique stressors inherent in rural life and inequitable access to appropriate services. This chapter canvases these issues and includes a brief discussion of optimally integrated care, risk factors and needs specific to rural people, the impact of Indigeneity, the role of socioeconomic factors in general and mental health, and inequity of access to primary mental healthcare services. These factors are illustrated by focusing on Australia as a case study, exemplifying both generic characteristics and those unique to that country that are relevant to service delivery in rural areas. The chapter was accepted for publication prior to Australia's worst bushfires on record (in the summer of 2019-2020), subsequent floods in early 2020, and the advent of the COVID-19 pandemic in February-March 2020 (ongoing). Most of the highlighted factors, however, remain the same -albeit greatly exacerbated by these extraordinary events. Information is provided in relation to the distribution of four relevant mental health specialties, with recommendations made-specific to Australia and also in the global context-with regard to optimally integrated primary mental health care.Across the settled world, there is a huge need to systematically roll-out integrated mental health services, using a number of modalities, to meet rural need. It is recommended that changes include: interprofessional education to facilitate team-based care;co-location of multidisciplinary primary healthcare teams;development and integration of culturally appropriate health services for Indigenous clients;mapping of required services in regional, rural, and remote areas;and optimal and strategic use of available funding and telehealth options. It is also strongly recommended that integration of lifestyle interventions be included in all mental health treatment, to facilitate optimal outcomes. These initiatives are now particularly pertinent, given the post-COVID "mental health pandemic" predicted by health experts globally. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Women CIOs in higher education pursuing work-life balance/integration, self-care, and the influence of COVID-19

There is a gender gap within higher education (HE) administration, and specifically the Chief Information Officer (CIO) position. This is a problem because men and women administrators provide diverse perceptions and advantages to HE institutions. The CIO perspective is important because they perform a critical role in the IT management and organization of HE institutions. Additionally, women in leadership positions often face additional pressures and barriers as compared to their men counterparts when seeking to integrate their work, family, and personal self-care. Thus, to further understand and take action to improve representation of women HE CIOs, the purpose of this study was to examine the experiences and perspectives of women HE CIOs and their ability to find and maintain work-life balance/integration with their roles as a worker, family member, and self-care and the significant impact of the novel COVID-19 pandemic in the pursuit of this goal. In this study, I used qualitative case study methodology and liberal feminist lens to explore the work-life balance/integration journeys, views, and practices of three women working as CIOs in HE institutions. The work-life journeys these women CIOs experienced were complex and inspiring. They hold the demanding and intricate responsibilities of the technology management and development within their respective institutions. They work long hours, endure the stress and pressure associated with this position, and adjust to enormous strain when necessary, such as momentous impact of COVID-19. They spend much of their energy toward the obligations and enrichment of their careers and their passion for this work is evident. They also acknowledge the impact work has on their home and personal lives. They organize their roles and responsibilities according to priority and recognize the importance of their own wellbeing and practices of self-care as major factors in the success of their other roles. Ultimately, the pursuit and maintenance of work-life balance is an ever-evolving yet crucial aspect of these women HE CIOs lives. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Are we starting to 'think family'? Evidence from a case file audit of parents and children supported by mental health, addictions and children's services

The Health and Social Care Board in Northern Ireland commissioned an audit of social work case files from across service teams to establish whether Think Family Northern Ireland (Think Family NI) and FFP have become embedded across three different services (Community Mental Health Teams (CMHTs), and addictions and children's services). The audit sought to: identify the extent to which these services co-worked to support families;highlight good practice;and identify areas for improvement. A random sample of files was selected from the three services in four of the five Health and Social Care Trusts, the main statutory provider of services in Northern Ireland. Data were collected from 108 case files. The COVID-19 lockdown ended fieldwork prematurely and electronic data from some files were unavailable (n = 12). Of the 103 families in the final sample, the mother was the primary focus in 85% of cases and, in total, parents had caring responsibilities for 258 children, the majority of whom were aged under 16 years. Joint planning was only evident in 18.5% of cases. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Examining the relationship between readiness and outcomes in clinical practices implementing integrated care

The integration of behavioral health and primary care (i.e., "integrated care") is a method to improve health equity and improve health outcomes. However, more research is needed to understand the relationship between practice readiness, implementation, and outcomes of integrated care over time. Therefore, this study involves a mixed methods retrospective process evaluation to explore the relationship between readiness factors and outcomes in clinical practices two-and-a-half to three-and-a-half years following a capacity-building program. During that program, practices completed assessments of their readiness to implement integrated care using the Readiness for Integrated Care Questionnaire (RICQ). At follow-up, we conducted surveys, qualitative interviews , and quantitative analyses with eight key informants from eight clinical practices to assess and explore (1) how readiness is associated with (a) sustainability of integrated care, (b) other implementation outcomes in integrated care, and (c) client outcomes in integrated care;(2) which readiness subcomponents are most influential in integrated care;(3) how practices build and/or maintain readiness for integrated care over time;and (4) other contextual factors, including Covid-19, that influenced sustainability of integrated care. Exploratory quantitative analyses suggest that the RICQ total scores were moderately to strongly positively correlated with self-ratings of practice sustainability, acceptability, fidelity, and achievement of client outcomes, and there was a small correlation with implementation cost. Follow-up surveys and interviews indicated the readiness subcomponents that were most influential throughout implementation as facilitators and barriers to implementation, sustainability, and achieving outcomes. Priority, program champion, innovation specific knowledge and skills, and supportive climate were key facilitators to integrated care. This study also highlights strategies practices used to sustain or build readiness, including systematic tracking of data, integrated care training programs, billing practices, top-down mandates for integrated care, regular communication, and hiring practices. Finally, the Covid-19 pandemic's influence on readiness for integrated care is explained in-depth, along with related readiness-building practices of telehealth and support for staff. This study has implications for the fields of integrated care and implementation science because it generates hypotheses about which elements of readiness impact implementation and sustainability of integrated care and offers strategies to build readiness for integrated care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)