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A model for a smooth transition to home care by improving "the quality"of information sharing among health care professionals who provide support for the shift

Research Project

Project/Area Number 17K12484
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Gerontological nursing
Research InstitutionJuntendo University

Principal Investigator

OGAWA Noriko  順天堂大学, 保健看護学部, 教授 (30621726)

Co-Investigator(Kenkyū-buntansha) 藤尾 祐子  順天堂大学, 保健看護学部, 准教授 (60637106)
酒井 太一  順天堂大学, 保健看護学部, 准教授 (50363734)
榎本 佳子 (黒川 佳子)  順天堂大学, 保健看護学部, 講師 (20637102)
鈴木 江利子  順天堂大学, 保健看護学部, 講師 (10805443)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Keywords地域医療連携 / 地域包括ケアシステム / 在宅療養移行支援 / ICT活用 / 情報共有システム / 多職種連携 / 退院支援看護師 / 訪問看護師 / ICT活用情報共有 / 退院支援 / 訪問看護 / 在宅看護 / 情報の連携システム / 連携尺度 / 顔の見える関係性 / 多職種間の相互理解 / 地域のリソース / ICT情報共有の質
Outline of Final Research Achievements

The present study examined interprofessional collaboration among home-visit and discharge-support nurses in community health, nursing, and welfare care. Their regional interprofessional collaboration was assessed using a “collaboration scale”. Although conferences were held and information was provided at the time of discharge, the following problems were extracted: insufficient collaboration with pharmacies, home-visit medical and nursing care, and professional home-visit health care services.
As “support for a smooth shift” from hospital to home care eliminates the bottleneck in the comprehensive community care system, the present study focused on methods for information sharing among different health care professionals, including busy discharge-support nurses in acute care wards and home-visit nurses in the community. The study also examined whether the quality of ICT-based information sharing among many different professionals influences their collaboration in the community.

Academic Significance and Societal Importance of the Research Achievements

本研究では、病院から在宅への移行支援が、地域包括ケアシステムでのボトルネックと捉え、在宅療養移行の困難事例や医療依存度の高い事例に関係する退院支援看護師および訪問看護師を対象として、地域を巻き込んだ多職種間の医療連携における『情報共有の質』が地域連携・協働実践の専門職者連携に影響することを検証した。
情報共有システムを取り入れた「医療モデルから生活モデルへ」連携・協働実践IPWモデルの構築により、コストの効率化、サービスの改善、在宅療養者のQOLの質の改善等に貢献する。本モデルと先行研究の専門職連携教育とを連動させ、看護系大学を中心としたコミュニティケアシステムとして高齢地域社会に浸透させる。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (18 results)

All 2019 2018 2017

All Journal Article (3 results) (of which Peer Reviewed: 3 results,  Open Access: 3 results) Presentation (15 results) (of which Int'l Joint Research: 8 results)

  • [Journal Article] 静岡県東部地域における医療介護福祉専門職者間の地域連携・協働(IPW)の現状と課題)2019

    • Author(s)
      小川典子・藤尾祐子・鈴木江利子・榎本佳子・酒井太一
    • Journal Title

      順天堂保健看護研究

      Volume: 8 Pages: 36-50

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Current Status and Challenges of Community Medical Liaison through Inter-professional Work (IPW)2019

    • Author(s)
      Noriko Ogawa, Yuko Fujio, Eriko Suzuki, Taichi Sakai
    • Journal Title

      International Journal of Medical Science and Health Research

      Volume: ISSN: 2581-3366

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] “Effectiveness of an IPE Model in Home-based Nursing Training to which Transitional Home Health Care has been Introduced”2017

    • Author(s)
      Noriko Ogawa. Yuko Fujio. Eriko Suzuki
    • Journal Title

      International Journal of Medical Science and Health Research

      Volume: Vol. 1, No. 02 Pages: 42-56

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Current Status and Challenges of Community Medical Liaison through Inter-professional Work (IPW)2019

    • Author(s)
      Noriko Ogawa. Yuko Fujio. Eriko Suzuki
    • Organizer
      ICN Congress 2019In Marina Bay Sans,Singapore
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Effectiveness of an IPE Model in Home-based Nursing Training to which Transitional Home Health Care has been Introduced2019

    • Author(s)
      Noriko Ogawa. Yuko Fujio. Eriko Suzuki
    • Organizer
      日中看護国際SYMPOSIUM-明日に連ぐ日中看護交流―
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 訪問看護師を要とした在宅療養移行支援の実態および課題2019

    • Author(s)
      小川典子、藤尾祐子、鈴木江利子
    • Organizer
      日本在宅ケア学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 退院調整看護師から見た在宅療養移行支援の実態および課題2019

    • Author(s)
      小川典子、藤尾祐子、鈴木江利子
    • Organizer
      日本看護福祉学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Current Status and Challenges of Community Medical Liaison through Inter-professional Work - A Questionnaire Survey Using a Community Liaison Scale -2019

    • Author(s)
      Noriko Ogawa, Yuko Fujio, Eeiko Suzuki
    • Organizer
      ICN Congress-Singapore
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research
  • [Presentation] 看護職を要とした在宅療養移行支援の実態および課題2018

    • Author(s)
      小川 典子、藤尾 祐子、鈴木 江利子、山本 多恵子
    • Organizer
      日本在宅看護学会
    • Related Report
      2018 Research-status Report
  • [Presentation] Effectiveness of an IPE Model in Home-based Nursing Training with the Introduction of Transitional Home Health Care2018

    • Author(s)
      Noriko Ogawa, Yuko Fujio, Eeiko Suzuki
    • Organizer
      2nd Global Conference on Nursing & Healthcare
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research
  • [Presentation] ナイチンゲールの在宅看護理論2018

    • Author(s)
      小川 典子
    • Organizer
      ナイチンゲール研究学会
    • Related Report
      2018 Research-status Report
  • [Presentation] 医療介護福祉専門職者間における地域連携・協働の現状と課題2018

    • Author(s)
      小川 典子、藤尾 祐子、鈴木 江利子、山本 多恵子
    • Organizer
      日本在宅ケア学会
    • Related Report
      2018 Research-status Report
  • [Presentation] Effectiveness of an IPE Model in Home-based Nursing Training to which Transitional Home Health Care has been Introduced2018

    • Author(s)
      Noriko OGAW. Yuko FUJIO. Eriko SUZUKI
    • Organizer
      International Journal of Medical Science and Health Research (IJMSHR)
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] 医療介護福祉専門職者間における地域連携・協働の現状と課題―「連携尺度」質問紙票を用いた検討―第2報―2018

    • Author(s)
      小川典子、藤尾祐子、鈴木江利子
    • Organizer
      第23回日本在宅ケア学会学術集会
    • Related Report
      2017 Research-status Report
  • [Presentation] Strategies for Home Nursing in the 21st Century Conceptualized by Florence Nightingale2017

    • Author(s)
      Noriko OGAWA
    • Organizer
      International Nursing Research Conference, October 20-22, 2017, Thailand
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] Investigation of the quality of care plans regarding “nutrition improvement”2017

    • Author(s)
      Yuko FUJIO. Yoshiko KUROKAWA. Noriko OGAWA
    • Organizer
      International Nursing Research Conference, October 20-22, 2017, Thailand
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] 静岡県東部の医療介護福祉専門職者間における地域連携・協働実践(IPW)の現状―第1報―2017

    • Author(s)
      小川典子、藤尾祐子、鈴木江利子
    • Organizer
      第7回在宅看護学会学術集会
    • Related Report
      2017 Research-status Report
  • [Presentation] Relationship between ICT usage for care planning and information-sharing in nursing care insurance services.2017

    • Author(s)
      Yoshiko KUROKAWA. Yuko FUJIO. Kazutoshi FURUKAWA. Megumi KODAIRA. Noriko OGAWA
    • Organizer
      2017ASHS Congress in BUSAN
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research

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Published: 2017-04-28   Modified: 2021-02-19  

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