Literature Collection

The Depart Process system, which included an electronic discharge checklist, standardized the hospital discharge process to improve care management of patients as they transition from a hospital to a primary care setting.

Follow up care after an abnormal developmental screening may be challenging for families, particularly those from under resourced communities. In this study, we examined how an existing integrated primary care (IPC) co-located model could address the needs of families whose children faced developmental concerns by conducting qualitative interviews to inform the adaptation to include developmental services. Data from 51 caregivers of pediatric patients (4 months to 6 years old) were analyzed qualitatively and coded using the Consolidated Framework for Implementation Research (CFIR) in combination with grounded theory to identify themes. Following coding with the CFIR framework, a thematic analysis was conducted for overarching themes in the data with the gradual development of codes and categories in an inductive manner. The thematic analyses identified three major themes: components of effective referrals, barriers, and caregiver preferences. The current study provides in-depth, contextualized information about how current IPC models can be expanded to address developmental concerns.

BACKGROUND: Ethnic inequities in maternity care persist in England for Black, African, Caribbean and mixed-Black heritage families, resulting in poorer care experiences and health outcomes than other minoritised ethnic groups. Co-production using an integrated care approach is crucial for reducing these disparities and improving care quality and safety. Therefore, this study aimed to understand the alignment of health and local authority professional perspectives with community needs on how to improve maternity experiences for this ethnic group within a London integrated care system (ICS). METHODS: Between March and June 2024, five workshops were conducted with health professionals, local authorities, voluntary, community and social enterprise (VCSE) sector and the public from Black, African, Caribbean and mixed-Black heritage backgrounds across the North West London ICS. Using the nominal group technique (NGT), attendees prioritised ideas to improve the experience of maternity care for families from Black, African, Caribbean and mixed-Black heritage backgrounds, which were thematically synthesised using framework analysis. RESULTS: Fifty-four attendees, covering primary, secondary, regional and national health professionals, public health teams from three local authorities, VCSE sector and the public, generated 89 potential interventions across 11 themes. All attendees prioritised improving staff knowledge and capacity in culturally competent care and communication. Community-identified needs for advocacy mechanisms and mental health support throughout the maternity pathway were not reflected in professional priorities. CONCLUSION: The study highlights the need for an integrated, community-centred approach beyond hospital settings when addressing ethnic inequities in maternity care, recognising key differences between community and professional priorities within an ICS. Leveraging lived experience expertise to lead the NGT community workshops was essential in building trust and buy-in of the overall prioritisation process.