Table 3.
The second order (themes) and third order (a priori concepts from the integration framework) constructs from the meta-ethnography
| Third order integration concepts | Second order constructs or themes | |
|---|---|---|
| Clinical integration | Functional | Appropriately trained and suitably accountable clinical staff undertaking roles, e.g. Medicines reconciliation |
| Accurate and timely recording of clinical information | ||
| Accessibility to complete and accurate patient/resident information | ||
| Normative | Patient-provider relationship that strives to involve the patient with person-centred delivery | |
| Clinical prioritisation to acknowledge high-risk patients/residents for intervention targeting | ||
| Professional integration | Functional | Professional roles and responsibilities that are not reliant on individuals, but are integral to holistic healthcare package |
| Clear professional role and responsibility descriptions that are mandated | ||
| Normative | Interprofessional buy-in to coordinate services | |
| Personal relationships/understanding between professionals | ||
| Established understanding of roles and responsibilities | ||
| Organisational integration | Functional | Integration of interventions within existing organisational pathways |
| Establishing an organisational workflow to support timely communication and care coordination | ||
| Mandated inter-organisation relationships between hospital and nursing homes | ||
| Normative | Established informal relationship or affiliation between hospital and nursing home | |
| Embedding an inter-organisational culture of collaboration that is not reliant upon individuals | ||
| Engagement activities and monitoring of performance within organisations | ||
| System integration | Functional | Digital integration where electronic health records are shared across care settings |
| Access and reference to the same resources for patients across settings | ||
| Electronic functionality to facilitate automation of interventions | ||
| Real-time data transfer with read–write capability | ||
| Supportive remuneration for collaborative working | ||
| Well-resourced organisation to support service delivery | ||
| Normative | Shared goals around patient safety and patient care |