Barriers and enablers to good communication and information-sharing practices in care planning for chronic condition management
Sharon Lawn A E , Toni Delany B , Linda Sweet C , Malcolm Battersby A and Timothy Skinner DA Flinders Human Behaviour and Health Research Unit, Margaret Tobin Centre, Flinders University, PO Box 2100, Adelaide, SA 5001, Australia.
B South Australian Community Health Research Unit, Southgate Institute for Health, Society and Equity, Flinders University, PO Box 2100, Adelaide, SA 5001, Australia.
C School of Nursing and Midwifery, Flinders University, PO Box 2100, Adelaide, SA 5001, Australia.
D Psychological and Clinical Sciences, Charles Darwin University, Orange 1, Casuarina Campus, Darwin 0810, Australia.
E Corresponding author. Email: sharon.lawn@flinders.edu.au
Australian Journal of Primary Health 21(1) 84-89 https://doi.org/10.1071/PY13087
Submitted: 2 April 2012 Accepted: 16 September 2013 Published: 1 November 2013
Abstract
Our aim was to document current communication and information-sharing practices and to identify the barriers and enablers to good practices within the context of care planning for chronic condition management. Further aims were to make recommendations about how changes to policy and practice can improve communication and information sharing in primary health care. A mixed-method approach was applied to seek the perspectives of patients and primary health-care workers across Australia. Data was collected via interviews, focus groups, non-participant observations and a national survey. Data analysis was performed using a mix of thematic, discourse and statistical approaches. Central barriers to effective communication and information sharing included fragmented communication, uncertainty around client and interagency consent, and the unacknowledged existence of overlapping care plans. To be most effective, communication and information sharing should be open, two-way and inclusive of all members of health-care teams. It must also only be undertaken with the appropriate participant consent, otherwise this has the potential to cause patients harm. Improvements in care planning as a communication and information-sharing tool may be achieved through practice initiatives that reflect the rhetoric of collaborative person-centred care, which is already supported through existing policy in Australia. General practitioners and other primary care providers should operationalise care planning, and the expectation of collaborative and effective communication of care that underpins it, within their practice with patients and all members of the care team. To assist in meeting these aims, we make several recommendations.
Additional keywords: care plan, collaboration, interdisciplinary care, primary health care, self-management.
References
Adams RJ (2009) Health literacy: a new concept for general practice. Australian Family Physician 38, 144–147.Department of Health and Ageing (2012) MBS online Medicare benefits schedule. (Australian Government: Canberra) Available at http://www9.health.gov.au/mbs/search.cfm?q=10997&sopt=I [Verified 6 June 2013]
Department of Veterans’ Affairs (2013) The coordinated veterans’ care program. (Department of Veterans’ Affairs: Canberra) Available at http://www.dva.gov.au/health_and_wellbeing/health_programs/cvc/Pages/default.aspx [Verified 6 June 2013]
Fairclough N (2003) ‘Critical discourse analysis.’ (Routledge: London)
Flinders Human Behaviour and Health Research Unit (2012) The Flinders program. (Flinders University: Adelaide). Available at http://www.flinders.edu.au/medicine/sites/fhbhru/self-management.cfm [Verified 6 June 2013]
Ginsburg S (2008) ‘Colocating health services: a way to improve coordination of children’s health care?’ (Commonwealth Fund: New York)
Jowsey T, Jeon YH, Dugdale P, Glasgow N, Kljakovic M, Usherwood T (2009) Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study. Australia and New Zealand Health Policy 6, 22–29.
| Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 19735576PubMed |
Lawn S, Battersby M, Lindner H, Mathews R, Morris S, Wells L, Litt J, Reed R (2009) What skills do primary health care professionals need to provide effective self-management support? Seeking consumer perspectives. Australian Journal of Primary Health 15, 37–44.
| What skills do primary health care professionals need to provide effective self-management support? Seeking consumer perspectives.Crossref | GoogleScholarGoogle Scholar |
Lawn S, Delany T, Sweet L, Battersby M, Skinner TC (2013) Control in chronic condition self-care management: how it occurs in the health worker–client relationship and implications for client empowerment. Journal of Advanced Nursing
| Control in chronic condition self-care management: how it occurs in the health worker–client relationship and implications for client empowerment.Crossref | GoogleScholarGoogle Scholar | 23834649PubMed |
Liamputtong P, Ezzy D (2006) ‘Qualitative research methods.’ (Oxford University Press: Oxford)
Martin CM (2008) Improving chronic illness care: revisiting the role of care planning. Australian Family Physician 37, 161–164.
Mathers N, Roberts S, Hodkinson I, Karet B (2011) ‘Care planning: improving the lives of people with long term conditions.’ (Clinical Innovation and Research Centre, Royal College of General Practitioners: London)
Nancarrow SA, Booth A, Ariss S, Smith T, Enderby P, Roots A (2013) Ten principles of good interdisciplinary team work. Human Resources for Health 11, 19–29.
| Ten principles of good interdisciplinary team work.Crossref | GoogleScholarGoogle Scholar | 23663329PubMed |
National Health Priority Action Council (2006) ‘National chronic disease strategy.’ (Australian Government Department of Health and Ageing, Canberra)
Ozolins I, Donald M, Mutch A, Crowther R, Begum N (2010) Who knows they have a treatment plan? Australasian Medical Journal 1, 153–159.
Shortus TD, McKenzie SH, Kemp LA, Proudfoot TG, Harris MR (2007) Multi-disciplinary care plans for diabetes: how are they used? The Medical Journal of Australia 187, 78–81.
Simon J, Murray A, Raffin S (2008) Facilitated advance care planning: what is the patient experience? Journal of Palliative Care 24, 256–264.
Thille PH, Russell GM (2010) Giving patients responsibility or fostering mutual response-ability: family physicians’ constructions of effective chronic illness management. Qualitative Health Research 20, 1343–1352.
| Giving patients responsibility or fostering mutual response-ability: family physicians’ constructions of effective chronic illness management.Crossref | GoogleScholarGoogle Scholar | 20530403PubMed |
Turner-Stokes L (2009) Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clinical Rehabilitation 23, 362–370.
| Goal attainment scaling (GAS) in rehabilitation: a practical guide.Crossref | GoogleScholarGoogle Scholar | 19179355PubMed |