Table 4 Characteristics of the designed interventions by type and country
Joint meetings | Brazil Joint discussion of clinical cases in diabetes and mental health | Chile Joint virtual clinical conferences | Colombia Joint meetings for discussion of clinical cases and medical training | Mexico Joint training sessions |
|---|---|---|---|---|
Participants | – Doctors and other health professionals from PC and psychiatrists and endocrinologists of the network | – Doctors and other professionals from PC and SC in the network | – PC and SC doctors (PP) and other PC doctors (replica sessions) and other professionals of the network | – PC and specialists of the network |
Characteristics | – Discussion of clinical cases (diabetes and mental health) – In person, monthly, duration 4 h | – Discussion of cases, referral criteria and follow-up instructions (any pathology) – Online (platform), fortnightly, duration 2 h | – Discussion of cases, referral criteria and ongoing training (chronic diseases) – In person, monthly/every two months, duration 4/2 h according to the type | – Ongoing training, discussion of cases (maternal-perinatal and chronic) – In person, sporadic, 3 days, 8 h |
Monitoring (aspects, method) | – participation, satisfaction functioning – indicators and questionnaire for participants | – participation, usefulness, functioning, aspects for improvement – indicators, questionnaire and observation of non-participants | – participation, usefulness, functioning, aspects for improvement – indicators, focus groups and observation of non-participants | – participation – indicators |
Offline virtual consultations | Brazil Virtual consultations between levels | Mexico Virtual communication system between levels |
|---|---|---|
Participants | – Interested PC doctors, endocrinologists and psychiatrists | – Interested PC and SC doctors |
Characteristics | – asynchronous inter-level consultations for endocrinopathies and mental health – email, standardized forms – maximum response time: 8 days | – asynchronous inter-level consultations, agreements on referral criteria and protocol repository, in chronic diseases and maternal health – digital platform hosted on server, standardized forms – maximum response time: 3 days |
Dissemination and training | – Bulletins to centres, MHD webpage, dissemination in meetings – No training plan developed | – Active search for participants in each health centre – Training plan and users’ manual |
Monitoring (aspects, method) | – utilization, response time, barriers to use, dissemination and training – indicators, questionnaire | – utilization, response time, barriers to use – indicators, focus groups |
Shared care guidelines | Argentina Care agreement for patients with hypertension and diabetes | Brazil Diabetes shared care guidelines |
|---|---|---|
Participants | Selected PC and SC doctors, PP and management representatives (creation phase) | Doctors and other health professionals from PC and endocrinologists, and management representatives (creation phase) |
Phases | I) Creation: 1) characterization of care path; 2) joint meetings for clinical cases, 3) meetings to draw up guidelines II) Implementation | I) Creation: 1) joint meetings for clinical cases, 2) meetings to draw up guidelines II) Implementation |
Dissemination and training | – No dissemination or training plan developed | – dissemination in training meetings and material sent to units – group training sessions |
Monitoring (aspects, method) | – participation in creation – indicators | – participation in creation and training sessions, satisfaction with training sessions, knowledge and use of guidelines – indicators and questionnaires |
Others | Uruguay Strategy to promote use of referral and reply letter | Chile Induction program for working in the network |
|---|---|---|
Participants | – PC y SC doctors, PP (in charge of operations in each centre) | – Professionals of both care levels, but focusing on those starting to work in the healthcare network |
Characteristics | – Standardized forms, flow chart and regulations of use | – Bidirectional inter-level visits between PC and SC: in groups according to profile – Graphic and audio-visual informative dossier on the network. Intranet for dissemination of material – Pending creation of implementation plan for the program |
Dissemination and training | – Plan for implementation in healthcare units: delivery of material, dissemination and monitoring | |
Monitoring (aspects, method) | – utilization, quality of records, barriers and facilitators in implementation – indicators, observation and focus groups | – level of participation, usefulness, functioning, aspects for improvement – indicators, questionnaire and observation of non-participants |