Abstract
Context: While the concept of integrated care has gained significant importance in the Belgian and international healthcare landscape, the process of transforming hospital care into integrated health pathways remains underexplored. Integrated care, as an approach to organizing and coordinating healthcare services, ensures continuity of care and the alignment of the efforts of different health actors to holistically address the medical and psychosocial needs of the population. Despite its potential, key operational action frameworks have not yet been consolidated. In an integrated One Health context, it is essential to analyze the complex interactions in order to understand the key operational steps and levers for action.
Approach: This case study examines the implementation of an integrated health pathway for the medical and psychosocial care of pregnant women in the Walloon Region. This integrated health pathway is part of the Belgian federal and regional health priority projects focused on the first 1000 days and involves CHR Haute Senne, PACT organization (Plan d'Accompagnement Concerté Transversal), and the Born in Belgium tool. A SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis of this transformation was conducted according to the HSO 76000 standard and the Quintuple Aim framework. Our patient-centered approach views the patient as a key partner, including in the evaluation of the impact and continuous improvement of the integrated health pathway through the PREM’s (Patient-Reported Experience Measures) and PROM’s (Patient-Reported Outcome Measures) perspectives.
Results: Four critical levels of integration needed to transform traditional hospital care into integrated health pathways were identified: conceptual integration of a multidimensional health pathway, decision-making integration at macro, meso, and micro levels, population integration through an outreach approach, and partnership integration between health and social actors of the region for both hospital and non-hospital workers. The contributions of PREMs and PROMs have been crucial in the continuous improvement of the program and in identifying essential integration levels.
Implication: These findings lead to recommendations for work streams to enable medical and psychosocial care within the framework of an integrated health pathway.