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Mapping for conceptual clarity: Exploring implementation of integrated community-based primary health care from a whole system perspective

Title: Mapping for conceptual clarity: Exploring implementation of integrated community-based primary health care from a whole system perspective
Authors: Steele Gray, Carolyn; Wodchis, Walter P.; Baker, G. Ross; Carswell, Peter; Sheridan, Nicolette F.; Breton, Mylaine; Kenealy, Tim; McKillop, Ann; Parsons, John
Source: International Journal of Integrated Care; Vol. 17: Annual Conference Supplement 2017; A143 ; 1568-4156
Publisher Information: Ubiquity Press
Publication Year: 2017
Collection: International Journal of Integrated Care (IJIC)
Subject Terms: concept map; theory; integrated care; implementation; whole-systems
Description: Background: Studying implementation of integrated models of community-based primary health care takes a “whole systems” multidisciplinary approach to capture micro (patient/carer and provider), meso (organization) and macro (system/policy) factors. In new research studying the implementation of these integrated models intended to improve care for older adults with complex care needs, our project team adopted four theoretical perspectives to capture micro, meso and macro factors influencing implementation.Problem Statement: Four theoretical and disciplinary perspectives were adopted to guide data collection and analysis. These perspectives were guided by 1) Wagner’s Chronic Care Model as related to Ham’s 10 Dimensions of High Performing Chronic Care Systems addressing patient/caregiver and provider level perspectives; 2) the Organizational Context and Capabilities for Integrating Care framework capturing organizational and provider level perspectives; and 3) the Health Policy Monitor survey methodology covering system and policy level perspectives. The different perspectives capture a wide breadth of concepts; however there is also significant conceptual overlap across those frameworks. The nature of this overlap requires clarification in order to: 1) ensure efficient data collection at the case sites; and 2) guide inter-disciplinary data analysis.Theory/Methods: Concept mapping was used to identify connections between the concepts across perspectives. Novak and Canas (2007)’s methods and software CmapTools were used to first generate a descriptive map. We explored the conceptual links of the map using data from 1 case studies in Ontario collected as part of the iCOACH project.Results: The concept map reveals many links across policy/system, organizational, provider and patient/carer theoretical perspectives. Examination of the overlap between concepts related to care coordination reveals different meanings, approaches, and implementations, depending on from which perspective you start. For instance, from a ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://account.ijic.org/index.php/up-j-ijic/article/view/3451/4228
DOI: 10.5334/ijic.3451
Availability: https://account.ijic.org/index.php/up-j-ijic/article/view/3451; https://doi.org/10.5334/ijic.3451
Rights: Copyright (c) 2017 The Author(s) ; https://creativecommons.org/licenses/by/4.0
Accession Number: edsbas.484557E
Database: BASE