Prototype to implement Health and social care integration

Background: The Healthcare and social Integration (HC-S Integration) has been a main priority in Catalonia for more than 10 years. Despite all the efforts done, there are still difficulties in the HC-S integration. 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.

Approach: The goal is to help organizations advance in HC-S Integration through a guide and evaluation framework. The steps to develop the prototype began with a bibliographic review and with a reflection on what is the vision of the future towards which we want to go:

• People: the future is that people know their process and the professionals involved. They participate and their values, desires and abilities are respected.
• Professionals: they participate in the design of strategies, they know the resources available and how to deploy them. They know the impact of working together on people’s health
• Organisations: there is a culture of territorial integration, with commitments and measurable goals agreed between all parties.
• System: to achieve agreed goals and outcome-based incentives and support.

Methodology:

1. State of art: more than 50 healthcare and social entities answered a checklist of 20 items focused on 4 areas: process management, territorial governance, tools for professionals, and citizen participation
2. Design thinking. Debate sessions (more than 50 attendees) to agree key interventions and change management.
3. Socialization. The final design was drawn up in a participatory manner with the project's promotion committee, in which care professionals, non-care professionals and representatives of patient organizations participate.

4.Operationalization. To advance on integrated care implementation, a series of progress guidelines on the 4 key areas have been developed to help entities to advance in HC-S integration and in patient-centered care.

 

 

Results:

Checklist :  showed that the main shortcomings were a lack of instruments to measure results,  incentives for professionals, or  training for change management, and the absence of patient’s perspective implementation of integrated care

The prototype is focusing on 4 areas:

1.People’s empowerment: The care model must be based on people’s needs, taking into account their values and desires and assuring participation in co-create processes and circuits.

2.Tools and abilities for professionals: promote leadership, more functional orga-nization and continous communication between professionals.

3.Management of cross-cutting processes between areas of care: create smooth circuits and foster a culture of coordination between organizations.

4.Agreement and territorial governance: agreed goals and incentives between different areas and organizations.

Operationalization: a guideline for progress on patient-centered care has been used in a benchmark and has made it possible to identify the dimensions in which organizations must improve.

Implications: For health and social integration, there are 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 is a good strategy.