Service delivery model elements N=78
| All n (%) | Geriatric n (%) | Palliative n (%) | Sig† | |
| Method of supporting integrated working | ||||
| Collaborative working | 64 (82) | 46 (78) | 18 (95) | 0.17* |
| Case management | 61 (78) | 46 (78) | 15 (79) | 1.00* |
| Comprehensive assessment | 51 (65) | 36 (68) | 15 (79) | 0.36 |
| Actors-workforce | ||||
| Professional education | 76 (100) | 58 (100) | 18 (100) | 1.00 |
| MDT care | 54 (72) | 42 (73) | 12 (71) | 1.00* |
| Rehabilitation expertise training | 34 (50) | 27 (50) | 7 (50) | 1.00 |
| End-of-life expertise training | 18 (25) | 1 (2) | 17 (90) | <0.001* |
| Transformation-service model elements/components | ||||
| Patient family education | 60 (100) | 49 (100) | 11 (100) | 0.93 |
| Medication review | 51 (80) | 40 (77) | 11 (92) | 0.43* |
| Self-management | 48 (80) | 41 (84) | 7 (64) | 0.21* |
| Systematic risk screening | 47 (69) | 37 (70) | 10 (67) | 1.00* |
| Contact with GP or attending doctor | 46 (68) | 33 (65) | 13 (77) | 0.37 |
| Practical support | 41 (68) | 34 (69) | 7 (64) | 0.73* |
| Medical intervention | 52 (67) | 39 (66) | 13 (68) | 0.85 |
| Individualised MDT plan | 40 (61) | 29 (59) | 11 (65) | 0.69 |
| Complex/medication management | 37 (58) | 30 (59) | 7 (54) | 0.75 |
| Discharge planning | 36 (52) | 29 (55) | 7 (44) | 0.44 |
| Professional psychosocial support | 38 (51) | 26 (44) | 12 (80) | 0.01 |
| Team case rounds | 25 (40) | 18 (37) | 7 (50) | 0.37 |
| Early rehab assessment | 25 (38) | 21 (40) | 4 (29) | 0.54 |
| Advanced care planning | 23 (30) | 9 (16) | 14 (78) | <0.001 |
| Emergency response plan | 15 (21) | 12 (22) | 3 (20) | 1.00* |
| Spiritual support | 13 (18) | 2 (3) | 11 (79) | <0.001* |
| Bereavement support | 4 (5) | 0 (0) | 4 (25) | 0.002* |
| Transformation-mode of delivery | ||||
| Ongoing assessment | 66 (87) | 50 (86) | 16 (89) | 1.00* |
| Face-to-face and telephone | 41 (53) | 31 (53) | 10 (53) | 0.10 |
| Face-to-face interaction | 31 (40) | 23 (39) | 8 (42) | 0.81 |
| Access to inpatient beds | 21 (30) | 18 (32) | 3 (21) | 0.53* |
| Physician home visits | 11 (15) | 4 (7) | 7 (37) | 0.04* |
| 24-hour physician access | 6 (10) | 5 (11) | 1 (7) | 1.00* |
| Telephone only | 5 (6) | 4 (7) | 1 (5) | 1.00* |
| 24-hour home visits | 1 (1) | 1 (2) | 0 (0) | 1.00* |
| Online only | 1 (1) | 1 (2) | 0 (0) | 0.10* |
| Transformation-operational tools and guidance to support practice | ||||
| Standard comprehensive assessment | 38 (59) | 26 (55) | 12 (71) | 0.27 |
| Worldview-methods of integrated working | ||||
| Link to hospital | 57 (78) | 41 (72) | 16 (100) | 0.02* |
| Expert consult with other providers | 40 (58) | 24 (45) | 16 (100) | <0.001 |
| Link between community services | 31 (50) | 22 (45) | 9 (69) | 0.12 |
| Joint provision-health and social care | 7 (10) | 4 (7) | 3 (20) | 0.16* |
| Link to residential hospice | 5 (7) | 1 (2) | 4 (27) | 0.005* |
| Worldview-conceptual model | ||||
| Patient engagement | 71 (99) | 53 (98) | 18 (100) | 1.00* |
| Active patient participation | 67 (99) | 50 (98) | 17 (100) | 1.00* |
| Centrality of patient needs | 64 (91) | 46 (89) | 18 (100) | 0.33* |
| Patient goal driven care | 56 (81) | 40 (77) | 16 (94) | 0.16* |
| Ongoing/continuous care | 46 (67) | 33 (62) | 13 (81) | 0.16 |
| Joint decision-making | 38 (69) | 25 (61) | 13 (93) | 0.04* |
| Service driven care planning | 38 (54) | 34 (65) | 4 (21) | 0.001* |
| Needs and benefit-driven care planning | 33 (46) | 18 (35) | 15 (79) | 0.001 |
| Caregiver engagement | 32 (55) | 22 (50) | 10 (71) | 0.16 |
*Fisher’s exact test.
†Sig=significance for difference in presence of service delivery element between geriatric and palliative care studies.
GP, General Practitioner; MDT, Multidisciplinary Team.