Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol

dc.contributor.authorBracco, Mario Maia
dc.contributor.authorCintra Nunes Mafra, Ana Carolina
dc.contributor.authorAbdo, Alexandre Hannud
dc.contributor.authorBasile Colugnati, Fernando Antonio
dc.contributor.authorBernardina Dalla, Marcello Dala
dc.contributor.authorPiva Demarzo, Marcelo Marcos [UNIFESP]
dc.contributor.authorAbrahamsohn, Ises
dc.contributor.authorRodrigues, Aline Pacifico
dc.contributor.authorFerreira de Almeida Delgado, Ana Violeta
dc.contributor.authordos Prazeres, Glauber Alves
dc.contributor.authorTeixeira, Jose Carlos, Jr.
dc.contributor.authorPossa, Silvio
dc.description.abstractBackground: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. Methods/Design: A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of Sao Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560 patients was calculated to fit a valid logistic model. In addition, qualitative approaches will be used to identify subjective perceptions of providers about the implementation process and of patients about health system use. Discussion: This research project will gather relevant information about implementation processes for education and communication tools and their impact on human resources training, rates of readmission, and patient-related outcomes.en
dc.description.affiliationHosp Municipal Dr Moyses Deutsch, Sao Paulo, Brazil
dc.description.affiliationHosp Israelita Albert Einstein, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Sch Med, Sao Paulo, Brazil
dc.description.affiliationGaroa Hacker Club, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Juiz de Fora, Sch Med, Juiz De Fora, Brazil
dc.description.affiliationSecretariat Hlth Espirito Santo State, Espirito Santo, Brazil
dc.description.affiliationEMESCAM, Super Sch Sci Santa Casa de Misericordia Vitoria, Vitoria, Brazil
dc.description.affiliationFed Univ Sao Paulo UNIFESP, Paulista Med Sch, Sao Paulo, Brazil
dc.description.affiliationCtr Studies & Res Dr Joao Amorim CEJAM, Porto Alegre, RS, Brazil
dc.description.affiliationUnifespFed Univ Sao Paulo UNIFESP, Paulista Med Sch, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipBrazilian Ministry of Health and FAPESP through PPSUS grant [2012/51228-9]
dc.identifier.citationBmc Health Services Research. London, v. 16, p. -, 2016.
dc.publisherBiomed Central Ltd
dc.rightsAcesso aberto
dc.subjectHealth system integrationen
dc.subjectEvidence-based implementationen
dc.subjectHealth professional educationen
dc.subjectInterdisciplinary communicationen
dc.subjectPrimary health careen
dc.titleImplementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocolen