Introduction: The ”At the Forefront”-project is a major cooperative project between the Hospital of Southern Denmark, the four municipalities in southern Jutland Haderslev, Tønder, Aabenraa and Sønderborg. The general practitioners in these municipalities, The University College South Denmark, The Unit for Health Promotion Research and The Research Unit of General Practice at the University of Southern Denmark (SDU).
The project consists of three PhD-studies which cover either the Healthcare professionals’, the patients’ or the relatives’ perspectives on intersectoral collaboration and continuum of care before, during and after acute admission for the elderly. The present study covers the perspectives of the healthcare professionals.
Background: The density of elderly citizens is increasing. The group of >65-year-olds represents 20% of the Danish population which is expected to be 25% in 2040. The use of HealthCare resources increases by age. Statistics Denmark estimates, that 90% of the >90-year-olds will be admitted during a year. This is a challenge for the Danish HealthCare System, which constantly needs to produce more for fewer resources.
Organizational and structural changes of HealthCare in Denmark mean, that elderly patients are often treated by a multiple number of actors, connected to several specializations. To prevent adverse health outcome as example given functional decline, continuum of care is important for the elderly who are acutely admitted. Continuum of care is mostly challenged when patients transition between responsible actors, and efficient intersectoral and interdisciplinary collaboration are important.
Aim: The aim of this study is to analyze the healthcare professionals’ perspectives on and experience with intersectoral, interdisciplinary collaboration and continuum of care before, during and after acute admission of elderly >75-year-olds. Needs, facilitators and barriers for intersectoral and interdisciplinary collaboration and continuum of care will be addressed in the study.
Research questions:
- ”How can intersectoral- and inter-disciplinary collaboration and continuum of care for acutely admitted elderly >75-year-olds be characterized based on the healthcare professionals’ perspectives, knowledge and experience?”
- ”Which needs, facilitators and barriers for intersectoral- and inter-disciplinary collaboration and continuum of care can be identified in treatment of acutely admitted elderly >75-year-olds, where several actors are involved.
- ”Which recommendations can be generated, based on results from the first two research questions, on how to organize healthcare to strengthen intersectoral- and inter-disciplinary collaboration to secure greater continuum of care for elderly (>75 years), who are acutely admitted?”
Methods: The project is based on qualitative methodology and is carried out in three phases. The first phase addresses research question one and includes individual interviews with relevant healthcare professionals across sectors and professions. The second phase addresses research question two and consists of observations of interactions between healthcare professionals, patients and organization, when elderly acutely admitted patient transition between actors. Focus for the observations will be for, during and after the time of acute admission. In the third and last phase, the results from phase one and two are used in focus group interviews across sectors will be done to validate and generate new guidelines for organizing and structuring of healthcare for elderly acutely admitted patients (>75 years).
Results:
Based on the research questions the PhD project will result in three scientific articles. The articles will be published in international scientific peer-reviewed journals and subsequently be assembled into the final PhD dissertation.
The results will contribute to new knowledge, reveal needs, facilitators and barriers for intersectoral- and interdisciplinary collaboration and continuum of care for elderly (>75 years), who are acutely admitted. From these results, recommendations are made on how to organize healthcare to strengthen intersectoral- and inter-disciplinary collaboration, secure greater continuum of care, reduce functional decline and support healthy life years for elderly.
Supervisors:
Pernille Tanggaard Andersen, The Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark (main supervisor).
Christian Backer Mogensen, Focused Research Unit for Emergency Medicine, Hospital of Southern Denmark, Institute for Regional Health research, University of Southern Denmark.
Jens Søndergaard, The Research Unit of General Practice, Department of Public Health, University of Southern Denmark.
Helene Skjøt-Arkil, Focused Research Unit for Emergency Medicine, Hospital of Southern Denmark, Institute for Regional Health research, University of Southern Denmark.
Timeframe: 1st of September 2017 - 31st of August 2020.