دورية أكاديمية
How the Esther Network model for coproduction of person-centred health and social care was adopted and adapted in Singapore: a realist evaluation.
العنوان: | How the Esther Network model for coproduction of person-centred health and social care was adopted and adapted in Singapore: a realist evaluation. |
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المؤلفون: | Lim ELP; School of Health and Welfare, Jönköping University, Jönköping, Sweden liping.lim@ju.se.; SingHealth Office of Regional Health, Singapore Health Services, Singapore., Khee GY; Department of Pharmacy, Singapore General Hospital, Singapore., Thor J; School of Health and Welfare, Jönköping University, Jönköping, Sweden.; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden., Andersson Gäre B; School of Health and Welfare, Jönköping University, Jönköping, Sweden.; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.; Futurum, Region Jönköping County, Jönköping, Sweden., Thumboo J; SingHealth Office of Regional Health, Singapore Health Services, Singapore.; SingHealth Centre for Population Health Research and Implementation, Singapore Health Services, Singapore.; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore., Allgurin M; School of Health and Welfare, Jönköping University, Jönköping, Sweden. |
المصدر: | BMJ open [BMJ Open] 2022 Dec 23; Vol. 12 (12), pp. e059794. Date of Electronic Publication: 2022 Dec 23. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
مواضيع طبية MeSH: | Delivery of Health Care* , Hospitals*, Humans ; Singapore ; Social Support ; Sweden |
مستخلص: | Objectives: The Esther Network (EN) model, a person-centred care innovation in Sweden, was adopted in Singapore to promote person-centredness and improve integration between health and social care practitioners. This realist evaluation aimed to explain its adoption and adaptation in Singapore. Design: An organisational case study using a realist evaluation approach drawing on Greenhalgh et al (2004)'s Diffusion of Innovations in Service Organisations to guide data collection and analysis. Data collection included interviews with seven individuals and three focus groups (including stakeholders from the macrosystem, mesosystem and microsystem levels) about their experiences of EN in Singapore, and field notes from participant observations of EN activities. Setting: SingHealth, a healthcare cluster serving a population of 1.37 million residents in Eastern Singapore. Participants: Policy makers (n=4), EN programme implementers (n=3), practitioners (n=6) and service users (n=7) participated in individual interviews or focus group discussions. Primary and Secondary Outcome Measures: Outcome data from healthcare institutions (n=13) and community agencies (n=59) were included in document analysis. Results: Singapore's ageing population and need to transition from a hospital-based model to a more sustainable community-based model provided an opportunity for change. The personalised nature and logic of the EN model resonated with leaders and led to collective adoption. Embedded cultural influences such as the need for order and hierarchical structures were both barriers to, and facilitators of, change. Coproduction between service users and practitioners in making care improvements deepened the relationships and commitments that held the network together. Conclusions: The enabling role of leaders (macrosystem level), the bridging role of practitioners (mesosystem level) and the unifying role of service users (microsystem level) all contributed to EN's success in Singapore. Understanding these roles helps us understand how staff at various levels can contribute to the adoption and adaptation of EN and similar complex innovations systemwide. Competing Interests: Competing interests: ELPL is the lead coordinator of the Esther Network Singapore who facilitated the implementation and adaptation of the innovation in Singapore. GYK is one of the Esther coaches. The remaining authors declare no other competing interests. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
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فهرسة مساهمة: | Keywords: Change management; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; Organisation of health services; PUBLIC HEALTH; Quality in health care |
تواريخ الأحداث: | Date Created: 20221223 Date Completed: 20221227 Latest Revision: 20230103 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC9791430 |
DOI: | 10.1136/bmjopen-2021-059794 |
PMID: | 36564117 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2044-6055 |
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DOI: | 10.1136/bmjopen-2021-059794 |