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Healthcare providers’ perceptions of management's effectiveness in achieving safety culture improvements are low, and there is little information in the literature on the subject. Objective: The overall aim of this study was to examine the patient safety culture within an interprofessional team – physicians, nurses, nurse technicians, speech therapist, psychologist, social worker, administrative support – practicing in an advanced neurology and neurosurgery center in Southern Brazil.

The authors applied the safety attitudes questionnaire (SAQ) in a mixed methods study, with a quan→QUAL sequential explanatory approach.

In the quantitative phase, the authors found a negative safety climate through the SAQ. In the qualitative phase, the approach enabled participants to identify specific safety problems. For that, participants proposed improvements that were directly and quickly implemented in the workplace during the study. The joint analysis of the quantitative and qualitative data inferred that the information and reflections of the focus group participants supported and validated the SAQ statistical analysis results. This integrated approach illustrated the importance of various safety culture aspects as a multifaceted phenomenon related to healthcare quality.

This study provides explanations for why management is associated negatively with safety climate in healthcare institutions. In addition, the study provides a novel contribution adding value to mixed methods research methodology.

Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid population aging and few healthcare resources elevating risk of stroke and mortality. The purpose of this paper is to explore healthcare delivery risks for rural older adults with AF.

This qualitative study collected data from AF patients, healthcare providers and decision makers. Ten patients participated in six-month care journeys involving interviews, logs, photos, and chart reviews. In total, 13 different patients and ten healthcare providers participated in focus groups and two decision makers participated in interviews.

Three key health service risks emerged: lack of patient-focussed access and self-management; unplanned care coordination and follow-up across the continuum of care; and ineffective teamwork with variable perspectives among patients, providers, and decision makers.

This study extends the understanding of risks to the health system level. Results provide important information for further research aimed at interventions to improve health service delivery and policy change to mitigate risks for this population.

The purpose of this paper is to focus on the Integrated Care Transitions Project between the emergency department (ED) of a university hospital and primary health care (PHC) services in a large city in Southern Brazil was the focus of this study. Care transitions occurred through telephone contact for patients discharged from the ED to PHC.

This descriptive, exploratory qualitative research collected data via semi-structured interviews (n=14) including interns of health disciplines, advisors for interns, nurses, and physicians from the ED and PHC Family Unit. A thematic analysis of the data were conducted.

ED providers felt they gained increased knowledge of the care networks available for patients in the community. Connection between the providers in ED and PHC facilitated confidence in the services provided in the community and increased continuity of care for patients’ needs. The PHC providers recognized integration promoted communication and better care planning for patients discharged from ED. Integrated care made the work in the PHC easier and benefited the users.

The study evaluated a program available in one hospital. Generalizability may be limited as services in the ED were provided by professional residents and their advisors, not employees of the hospital.

Shared information by different health services leads to better care for patients and greater job satisfaction for providers.

Care transitions are not well-managed in health care; there is limited research focusing on care transitions from ED to community. For providers and patients, this program assisted in building capacity and networks for transitions in care.

The purpose of this paper is to document the influence of policy transfer on integrated care development, its global occurrence and shifts towards integrated care. It highlights the influence of supranational forces, and the roles and relevance of policy transfer and policy translation in the development of integrated care.

This paper presents the findings of an international review of the policy transfer of integrated care, and the relevance of policy translation in integrated care development.

The global occurrence in integrated care, as evinced in this paper, can be seen in the global shift towards integrated care in various countries. However, studies exploring the actual mechanism of policy transfer and policy translation in relation to integrated care across countries are limited. The study of integrated care through the lens of policy transfer is important, as it for example, explores the structural elements, including environmental and cognitive obstacles in the policy transfer process. Policy translation offers a social constructivist approach to explore the travel of ideas, and considers the multiple spatial and scalar contexts in which integrated care policy is implemented.

This paper aims to advance policy transfer and policy translation as complementary frameworks to explain integrated care development. Second, it seeks to make novel and useful contributions to the debate about the development of integrated care, and to the wider arguments on policy transfer and policy translation and integrated care in other parts of the world.