Index. C Canadian healthcare system, 128 care coordination, 183 5

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1 A absorptive capacity, 245 access to data, 43 4 action cards, 213 action research, 206 admissions, 74 adverse events, 73 advocacy, 92 4 ambulance stretchers, 125 Anchor agents, 208 Audit Commission, 6 Australian Commission on Safety and Quality in Health Care, 5 Australian Council for Safety and Quality in Healthcare, 8 Australian healthcare system, 180, 182 awareness of safety, 215 B baseline measures, 227 bed blocker, 110 bed moves, 108 best-practice model, blame culture, 111 Boyatzis model, 147 Boyatzis theory, 144 Bristol Royal Infirmary, 88 British Columbia Emergency Health Services, 128 British Vancouver Canadian emergency medical system, 126 C Canadian healthcare system, 128 care coordination, The Author(s) 2017 K. Aase, J. Waring (eds.), Researching Quality in Care Transitions, DOI /

2 296 Index care (cont.) pathway, 259 transitions, 3, 11, 283 care transition safety program, Care Transitions Intervention (CTI), 21 checklists, 205 chronic care model, 263 chronic health conditions, 183, 185 clinical handover, 7 clinical information, 127 clinical practice, 146 clinical practice guidelines, 259 co-designation, 79 cognitive competencies, 146 collective knowledge brokering, collective team work, 113 combination, 247 communication patterns, 205 protocol, 127 tools, 287 communities of practice, 152 competency, 116 approach, 150 gaps, 240 complex adaptive systems, 180 complex interactions, 181 complexity, 261, 286 Computerised Decision Aid for stroke thrombolysis, 136 conceptual changes, 285 conceptual model, 97 construct validity, 52 context, 264 context-specific design, 206 contextual factors, continuity of care, 10 conversations, 42 3 coordinated care systems, 260 Coordination Reform, 6 critical handover situations, 206 cross-boundary knowledge sharing, 175 cross-professional interaction, 174 cultural boundaries, 18 D decision-making, 125, 133, 170 delivery room, descriptive cross-sectional design, 50 dialogue, 252 dignity, 106 direct communication, 224, 225 discharge coordinator, 160 discharge liaison nurse, 166 Discharge of Elderly Questionnaire (DEQ), 50 discharge summary, 73 discussion platforms, 153 dissemination, E educational meetings, 240 effective job performance, 145 emergency, 123 care transitions, department, emotional safety, 111 empathy, care, 106, 115 practice, 117 stroke care, ethical questions, 36 evaluation studies, 270

3 297 Evaluation-Coordination Function Integrated Care, 269 evidence-based reflexivity, evidence-based working model, 192 explicit knowledge, 247 externalisation, 247 F face validity, 56 family involvement, 18 meetings, 97 care, 90 federated landscape, feedback, 78 81, 217 fidelity, 224 field notes, 40 1 follow-up, 224 frequent callers, 126 G generalizability, 65 General Practitioners (GPs), 224 generic hospital checklist, 214 genuine kindness, 115 geographical proximity, 59 group discussions, 251 Guttman scale, 63 H handover, 20 design process, 204 intervention, 205 procedures, 206, 230 process, 126 handover as it is, 210 Health Kinzigtal integrated care system, health promotion programmes, Healthwatch, 6 Healthy Kinzigtal (HK) project, 266 heuristic framework for Q-CAT, 284 hospital admission, 34 specialists, 224 I illness management, implementation process, 207, 212 science, implicit knowledge, 173 inapplicability, patient involvement barrier, 135 individual care plans, 184 knowledge brokers, 160 competencies, 145 informal caregiver, 88 relationships, 224 social relationships, 253 information brokering, 94 5 exchange, 240 informed written consent, 34 6 in-hospital handover, innovations teams, 208, 209 inpatient ward/unit, in-person interviews, 59 in situ simulation-based training, 215 integrated care, 10, 11, 80

4 298 Index integrated care contracts, 270 internalisation, 247 inter-organisation boundaries, 160 dynamics, 248 knowledge transfer, 241, 245 staff meetings, 153 inter-profession boundaries, 160 communication, 166, 170 interactions, 169 knowledge sharing, 167 interventions, 21 intra-organisational transfer capability, 246 J job tasks, K key learning points, knowledge boundaries, 17 brokering, brokers, 161 creation, 247 exchange, 162 interaction, 248 sharing, 160, 241 transfer, 163, 245 translation, 189 L leaders, 207 leadership, learning arena, 241, 253 learning tools, 248 legal precedent, 134 legitimate patient, lived experience, 90 locus of control, 91 logistic regression analysis, 62 M managerial continuity, 227 medically fit for discharge, 104, 151 Medicare, 128 Meeting Point programme, 241, 242 methodological challenges, 32, 287 methodology, 291 mingling, 251 missing data, 62 model of translational research, 192 motivation, 246 multi-disciplinary team meetings, 240 brokering, N National Health Services (NHS) Commission Board, 89 National Quality Board, 71 National Reporting and Learning System, 125 next of kin, 87 non-linear interactions, 182 Norwegian Coordination Reform, 89 Norwegian Health Personnel Act, 89 nurse desk brokering, nurse patient relationship, 106

5 299 O objective/explicit knowledge, 164 observational research, 37 observer backgrounds, 42 Occupational Therapists (OTs), 167 online surveys, 60 operating room, 212 operationalizing, 63 organization boundaries, 17 capacity, 182 environment, 150 forces, 174 frameworks, 217 learning, 224 orthogeriatric consultants, 167 P patient care, 74 carer-centred approaches, 291 demographics, 72 experiences of discharge, 73 family involvement, handovers, 8, 146, 203 role of, safety experience, 71 self-report survey, 80 stories, 11, 16 transfer, 125 personal contact, 224 person-centered nursing framework, 91 PHM. See population health management (PHM) pilot interviews, 56 population, 51 health, 260 health outcomes, 262 integrated care, 266 population health management (PHM), 261 post-discharge outcome, 64 Power, Organisation, Culture and Knowledge, 19 power relations, 246 pre-hospital emergency care, 123 PReSaFe, 79 primary care physicians, 43 profession boundaries, 17 competencies, 143, 144, groups, 166 responsibility, 89, 90, 147 Q Q-CAT framework, quality indicators, 240 questionnaire, 49 R reader s guide, 23 4 receiver, 248 recruitment, 57 8 of participants, 242 process, 32 7 referral letter, 224 reflexivity, 225 reflexivity meetings, 228 regional integrator, 267 regulation, 180 relational continuity, 227

6 300 Index relationships with staff, 113 reporting systems, 126 The Required Organizational Practices Handbook, 129 resilience theory, 206 response options, 55 retention, 36 7 risk assessments, 227 S safety culture, 224 experiences, 76 incidents, 72 4 management measures, 232 Safety-I, 77, 125 Safety-II, 76, 125, sample, 57 sampling strategy, 38 SBAR. See Situation, Background, Assessment, Recommendation (SBAR) secret second handover, 131 semantics, sender, 248 shadowing, 38 shared decision-making, 89 simulation, 208 simulation-based training, 216 situated standardization, 208 Situation, Background, Assessment, Recommendation (SBAR), 127 social bonds, 250 network analysis, 163 ties, 247 socialisation, 247 socialisation, externalisation, combination and internalisation (SECI) model, 248 spatial boundaries, 17 staff confidence, 112 stakeholder involvement, stakeholders, 212 statistic analyses, 61 methods, 49 power, 62 storytelling, 17 strategic alliance, 250 strategies for patient involvement, 76 stroke care trajectory, 107 stroke patient, strong muscles solid bones programme, 268 structural holes, 163 structured observation, 38 structures and mechanisms, 246 subjective/tacit knowledge, 164 support, 95 7 survey design, 50 system competency, T tacit, 247 taxonomy of participation, 54 team role awareness, 208, 216 telephone interviews, 59 TIIP. See Transitional Incident Prevention Program (TIPP) timing of data collection, 60 1 trajectory of stroke, 104

7 301 transformative research goals, 190 Transforming Emergency Health Services Action Plan, 130 transition care, 8 incidents, 231 risks, 226 safety, 229 study, 50 transitional care programme, 186 Transitional Incident Prevention Program (TIPP), 223, 226, 227 translational research, 189, 191, 192 trauma orthopedic (TO) unit, 165 treatment decisions, 135 Triple Aim model, 263 trust, 253 trust and advocacy, 116 trust and risk, 246 U user involvement, 207 V video reflexive ethnography, 233 W waiting patients, 112 white board, 213 WHO. See World Health Organization (WHO) WHO Health System Performance Assessment Framework, 262 WHO surgical checklist, 213 work-as-done, 131, 210, 211 work-as-imagined, 131 workplace learning, 152 World Health Organization (WHO), 5

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