Older persons' experiences of whole systems: the impact of health and social care organizational structures

McCormack, Brendan, Mitchell, Elizabeth, Cook, Glenda, Reed, Jan and Childs, Sue (2008) Older persons' experiences of whole systems: the impact of health and social care organizational structures. Journal of Nursing Management, 16 (2). pp. 105-114. ISSN 0966-0429

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Official URL: http://dx.doi.org/10.1111/j.1365-2834.2007.00823.x


Aim(s) An in-depth case study of whole systems working. Background This paper reports on the second part of a two-part study exploring whole systems working. Part 1 of the study focused on an in-depth review of the literature pertaining to continuity of care and service integration. The second part, reported here, focused on an in-depth case study of one whole system.
Informed by the findings of part 1 of the study, data collection methods included in-depth interviews, real-time tracking of 18 older people, focus groups and consensus conferencing. Different data sets were analysed individually and synthesized using matrices derived from the literature review findings.
Key issue(s)
Key themes from data synthesis include: (1) access to the most appropriate services; (2) service fragmentation; (3) continuity of care; and (4) routinized care. Conclusion(s) The four themes of the case study reflect the need to address issues of demarcation of professional responsibilities, complicated channels of communication, information flows, assessment and reassessment in whole systems working.
Implications for nursing management
The impact of disempowering relationships on actual continuity of care and perceptions of quality among service users and providers. Lessons need to be learnt from specialist services and applied to service delivery in general.

Item Type: Article
Subjects: B700 Nursing
Department: Faculties > Engineering and Environment > Mathematics, Physics and Electrical Engineering
Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: EPrint Services
Date Deposited: 10 Sep 2009 11:22
Last Modified: 12 Oct 2019 15:26
URI: http://nrl.northumbria.ac.uk/id/eprint/3494

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