Strategies used by case managers supporting frail, community-dwelling older persons, to engage primary care physicians in interprofessional collaboration

Van Durme, Thérèse;Cès, Sophie;Karam, Marlène;Macq, Jean
(2014) RCN 2014 Annual International Nursing Research Conference — Location: Glasgow, Scotland, UK (2.April.2014)

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Abstract
Background and aim Although it is known that case management for frail older persons (FOP) is more likely to foster positive outcomes when the case manager works closely with the primary care physicians (PCP) [1], engaging PCPs to collaborate is often a difficult process, especially when the case management function is new [2]. The aim of this study was to provide insight on how newly implemented case management projects managed to engage FOPs’ PCP in the case management process, (to what extent?)and with which results. Methods A stepped approach was used to build the data collection, as (qualitative and quantitative) data were collected annually (from/within)among the 21 case management projects financed by the Belgian National Institute of Health and Disability Insurance (NIHDI) from the start of the projects (April 2010) till June 2013 (from records? Interviews?...). At total of 4612 FOPs were included in the 21 case management projects. Data collection and inductive analysis were informed by D’Amour’s framework of collaboration [3]. Results The entry point for most of the projects to try to engage PCPs in the process was the need for the latter filling out the medical part of the comprehensive geriatric assessment (InterRAI-HC), a cornerstone of the case management process. Strategies to engage PCPs ranged from solely providing information to the GP of the FOP being in the project (8 projects) to provision of full feed-back about the results of the interRAI-HC (10 projects). Only parts of D’Amour’s framework were used to guide these strategies, explaining the mixed results of PCPs’ engagement. Discussion and conclusions Strategies used by case management projects remained timid and the perceived PCP engagement in the case management process, weak. More targeted strategies are needed to enhance PCPs’ involvement and the use of theoretical frameworks, such as D’Amour’s, to guide those strategies, is expected to facilitate PCPs’ involvement.
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Van Durme, T., Cès, S., Karam, M., & Macq, J. (2014). Strategies used by case managers supporting frail, community-dwelling older persons, to engage primary care physicians in interprofessional collaboration. RCN 2014 Annual International Nursing Research Conference, Glasgow, Scotland, UK. https://hdl.handle.net/2078.5/26280