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J.M. Hartgerink, J.M. Cramm, T.J.E.M. Bakker, R.A.M. van Eijsden, J.P. Mackenbach, A.P. Nieboer

The importance of relational coordination for integrated care delivery to older patients in the hospital. J.M. Hartgerink, J.M. Cramm, T.J.E.M. Bakker, R.A.M. van Eijsden, J.P. Mackenbach, A.P. Nieboer. Background I. 34-50% functional decline

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J.M. Hartgerink, J.M. Cramm, T.J.E.M. Bakker, R.A.M. van Eijsden, J.P. Mackenbach, A.P. Nieboer

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  1. The importance of relationalcoordinationforintegrated care delivery toolderpatients in the hospital J.M. Hartgerink, J.M. Cramm, T.J.E.M. Bakker, R.A.M. van Eijsden, J.P. Mackenbach, A.P. Nieboer

  2. Background I • 34-50% functionaldecline • Fragmented, duplicated and directed at acute disease • Integrated care delivery • coordinated response • horizontal work processes • complementary role

  3. Background II • Theory of relational coordination “mutually reinforcing process of interaction between communication and relationships carried out for the purpose of task integration”

  4. Setting and design • Cross-sectional study • Vlietland hospital, The Netherlands • Data collected in 2010 • 192 professionals (44% response rate)

  5. Questionnaires I • Relational coordination survey • Communication • frequency/timeliness, accuracyand problemsolving • Relationships • shared goals, shared knowledge and mutual respect • 4-point scale • Cronbach’s alpha 0.96

  6. Questionnaires II • Assessment of chronic illness care (ACIC) • Self-management support • Delivery system design • Decision support • Clinical information systems • 11-point scale • Cronbach’s alpha 0.87

  7. Results I - descriptives Relational coordination M = 2.57 (SD 0.95) Integrated care delivery M = 5.58 (SD 1.79)

  8. Results II – differences in disciplines • Geriatric unit compared to other hospital units: • Higher integrated care delivery • Higher relational coordination • Nurses compared to medical specialists: • Higher relational coordination • Same discipline compared to different disciplines: • Higher relational coordination

  9. Results III – multiple regression analysis * P < 0.001

  10. Conclusion • Relations, communication and coordination to improve integrated care • Value of geriatric unit • Less attraction to the unfamiliar discipline

  11. Discussion • Cross-sectional design • Confounders • Patient experiences and outcomes

  12. Practical implications • Expand geriatric awareness • Improve attraction to the unfamiliar discipline • Introduce training programmes • Redefine goals and objectives of teamwork

  13. The importance of relationalcoordinationforintegrated care delivery toolderpatients in the hospital J.M. Hartgerink, J.M. Cramm, T.J.E.M. Bakker, R.A.M. van Eijsden, J.P. Mackenbach, A.P. Nieboer

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