Crafting intermediate care: one team’s journey towards integration and innovation

Abstract

Aim

This paper describes one multi-disciplinary, multi-agency team’s development of Person-Centred Intermediate Care (PCIC) for older people. This development involved integrating three separate enterprises – a not-for-profit charitable organisation, a local primary health care trust and referring hospitals and their local social care providers.

Methods

We used a mixed-methods case study, underpinned by the notion of an innovation journey, to explore how PCIC was developed by the team and how effective it was. Data were collected through semi-structured interviews, documentary analysis, closed-end questionnaires/scales and routinely collected activity data. Thematic and statistical analyses were used. Results were triangulated. Twelve staff, four key informants and 94 service users participated.

Results

The development followed the trajectory of innovation journeys. Our mixed-methods approach enabled us to expose staff’s negative experiences during this time whilst patients were largely satisfied with their care and made appropriate recovery. The triangulation of data in this mixed-methods study allowed us to seek explanations for this mismatch. We conjecture that the staff used emotional labour to lessen the effects of their negative experiences for the benefit of the patients.

Conclusions

This paper extends our knowledge of how, in a policy environment that encourages collaborative practice between public, private and voluntary alliances, and across sectors, such innovations work. In addition, the results suggest that emotional labour is used during change and care practices: preparing nurses better in order to use this ‘technique’ is a recommendation from this research.

Keywords

intermediate care older people gerontology innovation and improvement inter-professional working nursing home mixed methods

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