BETTER TOGETHER - The short-term care centre as means for integrated care - a qualitative study

Abstract

The ageing population and healthcare reform leads to a changing demand for short-term care. Health-related care and service providers offer several types of short-term care, but lack a clear vision and associated real estate strategy. Therefore, care processes are not always arranged efficiently, and real estate does not add value to the performance of the organisation. This affects the quality of care that clients receive. The aim is to gain insight in the care processes of six different types of short-term care in order to establish 1) to what extent (horizontal) integration is possible, 2) to determine the requirements for real estate, and 3) to identify possibilities for organisational change. The intention is to increase insight into the possibilities and prerequisites of optimizing short-term care through a closer alignment with the real estate strategy.
A qualitative interview study (n=16) within one health-related care and service provider was conducted with respondents holding a management position. In order to add validity, two focus group sessions (n=10) were held to discuss the findings and identify barriers and prerequisites towards integrated short-term care.
Findings show that short-term care is currently paired with long-term care although the goals and care environments differ substantially. All types of intermediate care, geriatric rehabilitation, respite care and Wlz crisis care can be integrated to some extent from the care and client perspective, along with a general practitioner, day centre and primary care treatment centre. Concentration of services on a location or within a building that is not associated with long-term care is recommended. It can result in more efficiency, higher quality and integrated care, and better expectation management. The client’s preference of care close to home needs to be taken into account as well. Certain barriers on macro, meso and micro level were identified. Respondents indicate that clear communication and creating a physical identity through real estate can solve some of the discussed barriers.
A limitation of the research is that it was conducted within the boundaries of one organisation, limiting the transferability of the data due to the specifics of the organisation and context. Furthermore, real estate recommendations are made based on short-term care processes, but financial feasibility is not considered. This requires further research.