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Conference Abstracts

Assessing the State of Preparedness to Deliver Integrated Care in a National Health System by Developing and Applying the Project Integrate Conceptual Framework as a Tool

Author:

Áine Carroll

Prof. of Healthcare Integration and Improvement, University College Dublin/National Rehabilitation Hospital Co-Director, IE
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Abstract

1. Introduction:

Integrated care by definition aims that care delivery processes should work seamlessly. Moving from a current provider-centric system to one enabling integrated care delivery is a big journey. The Health Service Executive in Ireland decided to assess its position so as to plan the journey. While tools such as the Scirocco model (1) are recognised, they focus on the overall system. Ireland wanted to be person-centric in focussing on its field staff and their views, and saw potential in the Framework developed in the Integrate EU project (2).

2. Theory/Methods:

Assisted by a scientific group and an advisory group, the research team critically reviewed the Integrate Framework tool for content and style. They applied it as a web survey to all health service employees in Ireland, and as far as possible those in contracted partner services.

3. Results:

The tool was adapted as follows:

•           Some section headings were changed to make them person-friendly rather than systems terms

•           Sections were re-ordered

•           Some items were reworded to fit local terms and practices; some were dropped and some were split into two components

•           Introductory text asked respondents to assess the current position against the specified desirable situations

•           The binary Yes/No format was changed to a 5-point Likert scale

•           Three evaluation questions were added about the survey tool’s clarity, relevance, and ability to capture local issues

•           Three formative questions were added inviting the listing of 3 developments which would be beneficial, 3 current blockages, and 3 local successes

•           The survey was badged and styled as an HSE document

•           1701 responses were received

•           The results were triangulated by running nine half-day facilitated workshops involving staff and patients

Respondents expressed high satisfaction with the survey tool, and the two modes of application triangulated well. Clear priorities for system development to enable field staff to deliver care in a more integrated way emerged. This variant of the Integrate framework reformatted as an assessment tool seems to have utility as a bottom-up situation analysis.

4. Discussion:

This reworked tool, based on the analytic work of the Project Integrate analysis, seems a useful addition to the integrated care toolbox. One of its key values is its staff-centredness, giving service delivery staff direct input into analysis of problems and priorities.

5. Conclusions:

The Project Integrate Framework, reformulated and reformatted in this way, was successful.

6. Lessons learned:

The need for rephrasing from the language of principles to that of practice, and harmonisation with local settings.

7. Limitations:

This is a one country study – other settings will be different. The circulation was to all staff with an organisational email address. Some recipients such as kitchen and back office staff would not see it is relevant to them, but as they cannot be quantified the ‘target’ population, and thus the response rate, cannot be quantified. 

8. Suggestions for future research:

Replication in another health system.

1. https://www.scirocco-project.eu/scirocco-tool/

2. Calciolari S et al.. The Project Integrate Framework; http://www.projectintegrate.eu.com/wp-content/uploads/2017/04/The-Project-Integrate-Framework-TOP.pdf

How to Cite: Carroll Á. Assessing the State of Preparedness to Deliver Integrated Care in a National Health System by Developing and Applying the Project Integrate Conceptual Framework as a Tool. International Journal of Integrated Care. 2021;21(S1):135. DOI: http://doi.org/10.5334/ijic.ICIC20144
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Published on 01 Sep 2021.

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