Integraatio sote-palveluissa: sote-ammattilaisten kokemuksia ja näkemyksiä iäkkään tekonivelleikkauspotilaan hoitopolusta
Keywords:
care pathway, integrated care, older people, joint replacement surgeryAbstract
Developing the (integrated) care pathway for older joint replacement patient
This article examines the care pathway of an older surgery patient from the perspective of integrated care. The fragility, multimorbidity and memory problems of an older patient pose special challenges to the continuity of care, which must be taken into account in collaboration between specialised care (ESH), primary care (PTH) and social care. We use the concept care pathway as a metaphor for describing the patient's journey from home to home through different care providers.
The aim of the study was to examine the experiences of care professionals on the integration of the care pathway. 14 care professionals were interviewed (this included physicians, nurses, physiotherapists, social workers) from different care providers. The data was analysed by thematic analysis.
Inadequate preoperative assessment, incomplete referrals, blind spots of information and problems related to hospital discharge were identified as key points in the development of the care pathway.
The care providers involved in joint replacement surgery work quite separately from one another. Adopting the idea of an extended care pathway could enhance collaboration and demonstrate its added value. The results can be applied at the wellbeing services counties aiming towards integrated care.
