Daniel Poremski1, Deborah Wise Harris2, Deborah Kahan3, Daniel Pauly4, Molyn Leszcz5, Patricia O'Campo6, Donald Wasylenki7, Vicky Stergiopoulos7. 1. Institute of Mental Health, Singapore; St. Michael's Hospital Centre for Research on Inner City Health, Canada. Electronic address: Daniel.poremski@mail.mcgill.ca. 2. St. Michael's Hospital Centre for Research on Inner City Health, Canada. 3. University of Toronto Department of Psychiatry, Canada. 4. University of Toronto, Canada. 5. University of Toronto Department of Psychiatry, Canada; Mount Sinai Hospital, USA. 6. St. Michael's Hospital Centre for Research on Inner City Health, Canada; University of Toronto Dalla Lana School of Public Health, Canada. 7. St. Michael's Hospital Centre for Research on Inner City Health, Canada; University of Toronto Department of Psychiatry, Canada.
Abstract
OBJECTIVE: This study explored service user and provider perspectives on barriers and facilitators of continuity of care for frequent users of emergency departments (ED) participating in a brief intensive case management intervention. METHOD: We conducted semistructured interviews with 20 frequent ED users with mental health and addiction challenges participating in a brief intensive case management intervention, eliciting experiences of care and care continuity. We interviewed 13 service providers working with this population. We used thematic analysis to determine shared and unique barriers and facilitators to continuity of care, and we gave priority to themes reported by both service users and providers. RESULTS: Within fragmented systems of care, strong working relationships between service users and providers, timely access to coordinated services and seamless transitions to needed supports increased perceived care continuity. Barriers to continuity of care included difficulties engaging this population, short intervention duration and the lack of a single accountable service provider to address health and social needs. CONCLUSION: Although brief intensive case management interventions have the potential to improve continuity of care for frequent ED users, continuity of care, especially for people with complex health and social needs, may be compromised by program and personal characteristics as well as lack of broader system integration.
RCT Entities:
OBJECTIVE: This study explored service user and provider perspectives on barriers and facilitators of continuity of care for frequent users of emergency departments (ED) participating in a brief intensive case management intervention. METHOD: We conducted semistructured interviews with 20 frequent ED users with mental health and addiction challenges participating in a brief intensive case management intervention, eliciting experiences of care and care continuity. We interviewed 13 service providers working with this population. We used thematic analysis to determine shared and unique barriers and facilitators to continuity of care, and we gave priority to themes reported by both service users and providers. RESULTS: Within fragmented systems of care, strong working relationships between service users and providers, timely access to coordinated services and seamless transitions to needed supports increased perceived care continuity. Barriers to continuity of care included difficulties engaging this population, short intervention duration and the lack of a single accountable service provider to address health and social needs. CONCLUSION: Although brief intensive case management interventions have the potential to improve continuity of care for frequent ED users, continuity of care, especially for people with complex health and social needs, may be compromised by program and personal characteristics as well as lack of broader system integration.
Authors: Jennifer R Mammen; Colleen M McGovern; Judith D Schoonmaker; Ashley Philibert; Emma C Schlegel; Kimberly Arcoleo Journal: J Asthma Date: 2021-12-28