Abstract
This abstract outlines the implementation of evidenced-based design methodologies to develop an Integrated Service Delivery (ISD) model for the Irish Health Service Executive (HSE) Health Regions.
The initiative is a response to the Sláintecare reform and the Health Regions Implementation Plan, aiming to establish regional and local organisational structures that support and enable integrated care provision for the population of the Republic of Ireland, including health and social care service users, providers, and communities.
This initiative, aligned with co-production principles from the Health Services Change Guide and Public Service Design Principles, involves collaboration between the HSE Health Regions Programme Team, HSE Organisation Development and Design Team, and the Department of Health in Ireland. Ninety-eight individuals, comprising HSE staff, managers, partner agencies, policymakers, renowned Integrated Care experts, and patient advocacy groups, participated in a co-design methodology to evaluate high-level structural options for Integrated Service Delivery in Health Regions. The initiative aims to leverage the insights of those receiving and delivering services to inform integrated care practices.
The initiative employed evidence-based design methods, primarily guided by People’s Needs Defining Change – Health Services Change Guide (2018) and national government-endorsed design principles aligned with IFIC principles of Integrated Care. The project team strategically integrated these frameworks, conducting a comparative analysis to establish a robust evidence base for the design process.
Discover- Define -Empathise Three ISD workstream group events facilitated collaborative exploration of the Irish health service design challenge. Analyses of outputs identified patterns/user needs in alignment with IFIC Nine Pillars of Integrated Care.
Design-Ideate- Key stakeholder groups participated in individual and small group meetings over a 6 month period to generate solution-focused ISD options. Forums sought wider representation and feedback from GPs, Chief Academic Officer’s, frontline staff, service user partners and Chief Officer Groups.
Deliver-Prototype - Iterate- Frontline workshops tested and evaluated ISD structures with operational and clinical representation. The Department of Health's Irish Government Economic and Evaluation Service (IGEES) employed a rigorous Multi-Criteria Analysis, aligning with the Better Regulation Toolbox. The ISD workstream group completed the options appraisal process and a preferred ISD model was selected.
The evidence-based methodology outlined was applied in the practical development of advanced structural options for Integrated Service Delivery (ISD) within the Health Regions. The Multi-Criteria Options Appraisal not only produced a preferred high-level structural design for ISD but also generated valuable qualitative and quantitative data to guide forthcoming iterations of the design process and ultimately support final decision making on the model.
This initiative serves as a guiding blueprint for Integrated Service Delivery (ISD) model design for international stakeholders. It offers valuable insights for navigating ISD complexities and structures to support this. Inclusive engagement with diverse stakeholders, guided by co-production principles, underscores the significance of crafting solutions resonating with unique community needs. This approach aligns with the IFIC pillars of Shared Values and Vision, People as Partners in Care, System-wide Governance and Leadership, and Transparency of Progress, Results, and Impact.
Detailed design of the preferred model for ISD and implementation due to commence from June 2024.