Abstract
Background: The Healthcare and social Integration has been a main priority in Catalonia for more than 10 years. La Unió (Catalan Hospital, Health & Social Services Association) has elaborated, with the participation of care professionals, non-care professionals and representatives of patient organizations, a guide/prototype to help organizations advance in HC-S integration with 4 key areas: empowerment of citizens, promotion of professional leadership and interdisciplinary teams, shared management of processes between different providers, and territorial agreements with common objectives that allow the evaluation. To get things changed, the development of Progress guidelines on every key area is a good strategy.
Approach: Progress guidelines can be very helpful for organizations to measure the degree of maturity in some aspect. A progress guideline on person-centered care (PCC), one of the essential points in the guide for integrated care, was drawn up and applied to La Unió's 2023 benchmarking process where a total of 16 acute care (HC) and intermediate care (IC) entities and 12 primary care (PC) entities have participated.
Methodology: the elaboration of the PCC guideline was based on bibliographic review and a Delphi consensus with a group of experts with different backgrounds. After the tool was refined in comprehension and methodology for avaluation, it was sent to the 28 benchmark’s participants. Through the questionnaire, we could identify best practices and innovative projects that were shared among the participants in 2 workshops.
Results: The PCC guideline has evaluated 4 dimensions: training, methodological tools, commitment of the organization and type of projects carried out . The results are presented on a scale of 5 levels with 10 degrees (the highest the better).
The global degree of maturity achieved was 6.3 (level 3) in HC and IC and 4.9 (level 2) in PC with a range fron 2.3 to 9.2. For dimensions the scores were: training 4.5 (level 2); tools 6.1 (level 3); commitment 7.2 (level 4) and projects 7.1 (level 4). Most HC and IC organizations and half of PC entities have incorporated PCC into governance. Professionals training has begun in the most of providers, but with variability in the professional's profile trained, and projects of varying complexity have been developed, mostly on HC.
The 2 workshops allowed to share 9 innovative projects about co-creation with patients and caregivers, or transformation in delivering of services in accordance with patient’s preferences
Implications: The PCC is, nowadays, a subject of concern to the entities but is more developed in HC and IC than in PC. Only 25% of PC entities have carried out a PCC project. It would be necessary to enhance support tools for small entities to be able to develop a PCC. Also it is necessary to strengthen and facilitate the use of specific methodologies to collect user preferences and to increase patient’s and caregivers participation in all the healthcare facilities.