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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?

Authors: Caroline Longpré, Carl-Ardy Dubois

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Even though nurses are expected to play a key role in implementing integrated services networks, up to now their practice in this regard has received very little research attention. The aim of this study is to describe the extent to which the evolution of nursing practice in Quebec in recent years has converged with the requirements and efforts involved in services integration.

Methods

This descriptive study was carried out with 107 nurses working an integrated network of healthcare services in Quebec in four different care pathways: chronic obstructive pulmonary disease, autonomy support for the elderly, palliative oncology care, and mental health. Development model for integrated care (DMIC) was used, first, to examine the prevalence in each pathway of integrative activities, grouped into nine practice dimensions, and then to position each pathway in relation to the four phases of development for any integration process, as defined by the DMIC.

Results

Only one pathway had reached Phase 3, which involves expansion and monitoring of integration, whereas the others were still in the preliminary Phases 1 and 2 characterized by initiative and experimentation. Only two dimensions out of nine (‘quality of care’ and ‘interprofessional teamwork’) were prevalent in all the pathways; two others (‘transparent entrepreneurship’ and ‘performance management’) were in none of the pathways, and the remaining five (‘patient–family centered care’, ‘result-focused learning’, ‘delivery system’, ‘commitment’, ‘roles and tasks’) were present to varying degrees.

Conclusions

These results suggest that particular efforts should be made to bridge the significant gap between the pace of nursing practice transformation and the objectives of service integration. These efforts should focus, among other things, on the deployment of organizational, clinical, human, and material resources to support practice renewal and continuing education for nurses to prepare them for the requirements of integration.
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Metadata
Title
Implementation of integrated services networks in Quebec and nursing practice transformation: convergence or divergence?
Authors
Caroline Longpré
Carl-Ardy Dubois
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0720-8

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