GPCC Person-centred care research centre web site

This research centre web site contains a range of information, films, presentations, resources and links; from basic information on person-centred care to information on a wide range of individual research projects from health and elderly care and rehabilitation. It also contains news, events, scientific publications and implementation.

The Gothenburg University Centre for Person-centred Care (GPCC) is an interdisciplinary research centre, established in January 2010, with the support of the Swedish government's strategic investment in health and care research. Uniquely GPCC has evaluated the effects of person-centred care in controlled studies. This has established that person-centred care is capable of enhancing the efficiency of the care process. Apart from considerable monetary savings resulting from amongst other things shorter hospital stays, significant positive effects from a patient perspective have been seen, as care is adapted to each individual person and his or her resources are made use of.

(A summary commentary ...

GPCC Person-centred care research centre web site

This research centre web site contains a range of information, films, presentations, resources and links; from basic information on person-centred care to information on a wide range of individual research projects from health and elderly care and rehabilitation. It also contains news, events, scientific publications and implementation.

The Gothenburg University Centre for Person-centred Care (GPCC) is an interdisciplinary research centre, established in January 2010, with the support of the Swedish government's strategic investment in health and care research. Uniquely GPCC has evaluated the effects of person-centred care in controlled studies. This has established that person-centred care is capable of enhancing the efficiency of the care process. Apart from considerable monetary savings resulting from amongst other things shorter hospital stays, significant positive effects from a patient perspective have been seen, as care is adapted to each individual person and his or her resources are made use of.

(A summary commentary ...

17th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people"

The 16th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people" will incorporate the 5th World Congress on Integrated Care as it comes to Europe for the first time. It will take place in Dublin, Ireland, from the 8-10 May 2017. 

The conference themes include: Promoting the health and welfare of people, families and communities; Timely transitions: optimizing patient flow across care settings: Preventing and managing chronic disease: engaging and empowering people; Ageing health and well being; and Implementing integrated care.

For more information, please visit: http://www.integratedcarefoundation.org/icic17 

Elaboration of the Gothenburg model of person-centred care

OBJECTIVE:

In this paper, it is aimed to explore professionals understanding of PCC routines as they implement the GPCC model in a range of different settings.

METHODS:

It is conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects.

RESULTS:

Interviewees accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.

CONCLUSION:

This study illustrates what is needed for health-care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice.

Feasibility of an implementation strategy for the integration of health promotion in routine primary care: a quantitative process evaluation

Process evaluation is recommended to improve the understanding of underlying mechanisms related to clinicians, patients, contect and intervention delivery that may impact on trial or program results, feasibility and transferability to practice. The aim of this study was to assess the feasibility of the Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable") implementation strategy for enhancing the adoption and implementation of an evidence-based health promotion intervention in primary health care. 

Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight For the Future?

Integrated care has been recognised as a key initiative to resolve the issues surrounding care for older people living with multi-morbidity. Multiple strategies and policies have been implemented to increase coordination of care globally however, evidence of effectiveness remains mixed. The reasons for this are complex and multifactorial, yet many strategies deal with parts of the problem rather than taking a whole systems view with the older person clearly at the centre. 

Ghana's community-based primary health care: Why women and children are ‘disadvantaged’ by its implementation

Policy analysis on why women and children in low- and middle- income settings are still disadvantaged by access to appropiate care despite Primary Health Care (PHC) programmes implementation is limited. Drawing on the street- level bureaucracy theory, this article explored how and why frontline providers (FLP) actions on their own and in interaction with health system factors shape Ghana´s community-based PHC implementation to the disadvantage of women and children accessing and using health services. 

Using Patient Reported Outcomes Measures to Promote Integrated Care

Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life

Using the Project INTEGRATE Framework in Practice in Central Coast, Australia

Integrated care implies sustained change in complex systems and progress is not always linear or easy to assess. The Central Coast integrated Care Program (CCICP) was planned as a ten-year place-based system change. This paper reports the first formative evaluation to provide a detailed description of the implementation of the CCICP, after two years of activity, and the current progress towards integrated care.

Stakeholder Perceptions and Context of the Implementation of Performance-Based Financing in District Hospitals in Mali

To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa.

Integrated care for older people (ICOPE) implementation framework: guidance for systems and services

Alongside supporting community-level services, the Integrated Care for Older People (ICOPE) approach helps broader health and social care systems effectively respond to the diverse and complex needs of older people. The ICOPE Implementation Framework provides guidance for policy makers and programme managers to concretely assess and measure the capacity of services and systems to deliver integrated care at the community level.

The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOPE on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements.

A 10 Step Framework to Implement Integrated Care for Older Persons

An aging population, whose multi-morbidities and risk of frailty increase with age results in significant health and social care consumption. Increasing complexity amplifies fragmentation of care and results in sub optimal care outcomes. There is growing evidence base supporting effective service responses for older persons. These typically include multidisciplinary, community based teams providing services in or near to the older person’s home (the ‘what’). However, examples of systemic implementation are confined to smaller regions notably in Catalonia (Spain), Scotland and Singapore. This reflects the fact that the implementation of integrated care is problematic at scale. The need to attend to methods that support high autonomy professionals tasked with local implementation (the ‘who’) is a neglected area. This paper proposes a framework to implementing integrated care for older persons. In addition, it offers some initial empirical evidence that this approach has utility among managers and clinicians. In doing so seeks ...

Stakeholder Perceptions and Context of the Implementation of Performance-Based Financing in District Hospitals in Mali

To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa.

Multiple Perspectives Analysis of the Implementation of an Integrated Care Model for Older Adults in Quebec

Integrated care models for older adults are increasingly utilised in healthcare systems to overcome fragmentations. Several groups of stakeholders are involved in the implementation of integrated care. The aim of this study is to identify the main concerns, convergences and divergences in perspectives of stakeholders involved in the implementation of a centralised system-wide integrated care model for older adults in Quebec.

Implementing Integrated Community-Based Primary Healthcare: Applying the iCoach-Approach to Case Selection to Denmark

The iCoach approach to case selection focuses on innovative models of community-based primary healthcare (CBPHC) and their contexts. The aim of this study was to assess the possibilities and limitations of the approach based on Denmark, which differs in significant ways from the jurisdictions initially included.

Designing and Implementing Integrated Care Workshop

IFIC Ireland in partnership with the Health and Social Care Board of Northern Ireland (HSCBNI) and the Health Service Executive (HSE) Ireland will host a half-day workshop for academics, researchers, managers, clinicians, policy makers, users and carers of health and social care services across the island of Ireland. The workshop will be chaired by IFIC Ireland’s Chairperson and Director of Integrated Care HSCBNI, Dr. Sloan Harper.

Towards Integrated People-centered Maternal, Newborn, and Child Health Care in Mali

The World Health Organization (WHO), through its Framework on integrated people-centred health services adopted by Member States in 2016, has called for a fundamental shift in the way health services are funded, managed, and delivered.

In Mali, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project has been working with the Ministry of Health since 2013 to contribute to reducing maternal, neonatal, and child mortality and morbidity. As part of ASSIST’s larger partnership with WHO to contribute to the development of IPCHS in different contexts and settings to promote learning, the project proposed to conduct a pilot project in Mali to assess the promotion of people-centered approaches in clinical consultations by health providers during pregnancy and delivery at peripheral health centers.

Partnership and accountability in the era of integrated care: a tale from England

In England, the 2012 Health and Social Care Act was heralded to be among the most significant changes in policy for the National Health Service (NHS) since its inception in 1948. Yet a key theme of the policy, namely the intensification of competition in service provision, has not fully materialised.
The 2014 Five Year Forward View outlined visions for a more integrated health and care system in England. Subsequent guidance introduced new organisational forms, such as the so-called Sustainability and Transformation Plans and integrated care systems

Political struggles for a universal health system in Brazil: successes and limits in the reduction of inequalities

Brazil is a populous high/middle-income country, characterized by deep economic and social inequalities. Like most other Latin American nations, Brazil constructed a health system that included, on the one hand, public health programs and, on the other, social insurance healthcare for those working in the formal sector. This study analyzes the political struggles surrounding the implementation of a universal health system from the mid-1980s to the present, and their effects on selected health indicators, focusing on the relevant international and national contexts, political agendas, government orientations and actors.

The Generation of Integration: The Early Experience of Implementing Bundled Care in Ontario, Canada

By bundling services and encouraging interprofessional and interorganizational collaboration, integrated health care models counter fragmented health care delivery and rising system costs.
While research has been conducted on the facilitators and challenges of integration, there is less known about how integration is generated. This article explores the generation of integration through the dynamic interplay of contexts and mechanisms and of structures and subjects.

Comparison of family centered care with family integrated care and mobile technology (mFICare) on preterm infant and family outcomes: a multi-site quasi-experimental clinical trial protocol

Family Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes.

Comparative case studies in integrated care implementation from across the globe: a quest for action

Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems

SCIROCCO Exchange - Capacity-building support for integrated care

Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler of capacity-building support. However, effective knowledge transfer and capacity-building support requires dedicated support and infrastructure to ensure that the flow of appropriate information and knowledge between adopting and transferring entities is tailored to the local context and maturity of the particular healthcare system seeking the support. This is a precondition to help health and care authorities to build their capacity for the successful transition towards integrated care.

Maturity requirements of a Good Practice – Using the SCIROCCO tool to assess them

The SCIROCCO self-assessment tool is an online self- assessment tool with an objective to assess a region’s readiness for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing.

The SCIROCCO tool helps regions to:

• Understand the strengths and weaknesses of their regional context for integrated care  and inform national, regional and local policy-makers about potential areas of  improvement;
• Adopt and transfer integrated care good practices by identifying their maturity  requirements and requirements for the potential transferability and scaling-up;
• Facilitate multi-stakeholder dialogues on progress towards the implementation and  delivery of integrated care;
• Facilitate twinning and coaching activities that help regions and organisations to better  understand the local conditions that enable the successful deployment of integrated care.

The SCIROCCO tool has been tested in more than 60 and organisations ...

Implementing integrated care for multi-morbidity: analysis of experiences in 17 European programmes

Many countries are experimenting with new models of care provision and numerous integrated care programmes have been established internationally. However, little information is available on how to implement integrated care. The aim of this study was to provide more in-depth insights in the implementation of integrated care for developers and managers of integrated care programmes, policy makers, health insurers, and researchers.

Supporting integrated care in practice: Perceptions of a national support programme for the development of New Care Models in England

This paper investigates the perceptions of key informants on a national support programme for the development of New Care Models in England (2015/16 to 2017/18). It focuses on the perceived facilitators and barriers affecting the development and implementation of the New Care Models programme and offers some insight into the role of national level support in enabling local integration initiatives. Besides the paper demonstrates that analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex interplay among these factors create.

Making Integrated Care Happen

IFIC Ireland will host and facilitate a series of 6 webinars throughout 2020 titled ‘Making Integrated Care Happen’ which forms one of the key delivery mechanisms enabling knowledge mobilisation across all stakeholders with an interest in developing and implementing integrated care within the healthcare systems on the island of Ireland.

It is important that those taking integrated care forward are enabled to share their experience, success and failures with others. Spread and sustainability can be accelerated if innovators and leaders are supported to work together in learning networks through which information and intelligence can be shared. This helps to avoid the same mistakes being made, can avoid unnecessary duplication of effort and can help build commitment and support by enabling leaders to work together in a community of practice.

Implementation of patient-centred care: which organisational determinants matter from decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

Health and social care systems, organisations and providers are under pressure to organise care around patients’ needs with constrained resources. To implement patient-centred care (PCC) successfully, barriers must be addressed. Up to now, there has been a lack of comprehensive investigations on possible determinants of PCC across various health and social care organisations (HSCOs). Our qualitative study examines determinants of PCC implementation from decision makers’ perspectives across diverse HSCOs.

Comparing International Models of Integrated Care: How Can We Learn Across Borders?

Providers, managers, health system leaders, and researchers could learn across countries implementing system-wide models of integrated care, but require accessible methods to do so. This study assesses if a common framework could describe and compare key components of international models of integrated care.

Implementation of the Integrated Care of Older People (ICOPE) App in Primary Care: New Technologies in Geriatric Care During Quarantine of COVID-19 and Beyond

The COVID-19 pandemic due to a novel coronavirus (SARS-CoV-2) in December 2019 has rapidly spread worldwide. The mortality rate is about 2.3% in general population, with high human-to-human transmission of 0.41 (credible interval [0.27, 0.55]), and nasopharyngeal asymptomatic carriers act as vectors within the population. The World Health Organization (WHO) declared the pandemic on March 2020, and established objectives and action plan. First, WHO aimed at limiting the transmission of SARS-CoV-2, which required large isolation actions (country borders lockdown and individual quarantine). Second, WHO aimed at guiding and supporting the different health care systems across countries. Finally, developing therapeutic interventions appeared as a global priority as available evidence were still scarce. More than 860 clinical trials are ongoing worldwide.

Building integrated care as the cornerstone of our new reality

This webinar allowed decision makers and managers in health and health care to learn about the integrated care approaches that have been implemented and the considerations that have been made to address the continuum of care and support needs of individuals, beyond public health issues and crisis management.

Integrated Care for Older Adults: A Struggle for Sustained Implementation in Northern Netherlands

Integrated care has been suggested as a promising solution to the disparities in access and sustained high quality long-term care emerging in Europe’s ageing population. The Dutch integrated person-centred health service for older adults was based on two evidence-based models (the Chronic Care Model and the Kaiser Permanente Triangle). In this case study we assess the impact of the programme based on past evaluations, reflect on why it ended, lessons learned and ideas to take forward.

Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis

Integrated care is said to improve the way in which care is delivered. To support integrated care by ensuring close collaboration between involved stakeholders, information and communication technologies, especially telemedicine, are needed. Despite their potential, most telemedicine solutions never make it from pilot project stage to full implementation into usual care. Especially in integrated care scenarios, understanding of the barriers hampering successful telemedicine implementation and application is limited.

Approaches to integrating palliative care into African health systems: a qualitative systematic review

Africa is characterized by a high burden of disease and health system deficits, with an overwhelming and increasing demand for palliative care (PC). Yet only one African country is currently considered to have advanced integration of palliative care into medical services and generalized PC is said to be available in only a handful of others. The integration of PC into all levels of a health system has been called for to increase access to PC and to strengthen health systems. Contextually appropriate evidence to guide integration is vital yet limited. This qualitative systematic review analyses interventions to integrate PC into African health systems to provide insight into the ‘how’ of PC integration. Forty articles were identified, describing 51 different interventions. This study found that a variety of integration models are being applied, with limited best practices being evaluated and repeated in other contexts. Interventions typically focused on integrating specialized PC ...

Achieving integrated care: the need for digital empowerment

In this article, Knight and Burdett look at the complex challenges involved in integrating care systems as part of the NHS Long-Term Plan of 2019, and the importance of digitalising services and records for implementing this.

Medical and Old-Age Care Integration Model and Implementation of the Integrated Care of Older People (ICOPE) in China: Opportunities and Challenges

The demand for healthy old-age care is growing rapidly in China. The traditional old-age care model can no longer meet elderly patients’ demands for medical care and old-age care. To promote the development of medical care-integrated old-age care, a solution covering multiple aspects is necessary. In the context of the global development of healthy aging, China recently issued many policies to integrate old-age care with medical care, establishing protection for a large number of disabled elderly people. The Integrated Care of Older People (ICOPE) project is an international program developed by the World Health Organization. This paper reviews China’s medical and old-age care integration model and the opportunities and challenges in implementing the ICOPE in the context of healthy aging in China.

Implementing Integrated Care in Practice – Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland

The importance of multidisciplinary teams (MDTs) as critical implementation drivers emerged from this case study conducted with three pioneer sites implementing integrated care for older persons in Ireland as part of the Integrated Care Programme for Older Persons (ICPOP).

The study describes the practices of MDTs learning to deliver integrated care in service delivery settings, including the framework, resourcing, strategies, challenges and barriers they encounter.

New Zealand’s Integration-Based Policy for Driving Local Health System Improvement – Which Conditions Underpin More Successful Implementation?

The System Level Framework (SLMF) is a policy introduced by New Zealand’s Ministry of Health in 2016 with the aim of improving health outcomes by stimulating inter-organisational integration at the local level.

This study aimed to understand which conditions that vary at the local level are most important in shaping successful implementation of this novel and internationally significant policy initiative relevant to integrated care.

Implementing patient-centred integrated care for multiple chronic conditions Evidence-informed framework

Fifteen years ago, the term multimorbidity rarely appeared in chronic disease health care policies. Today, research has revealed very high rates of multimorbidity, leading to it being labeled the number one challenge in developed countries. Paradoxically, chronic disease prevention and management (CDPM) programs of integrated care have popped up in all health care systems but they mainly follow a single-disease approach in their interventions. In this article, we define CDPM programs broadly as any interventions intended to improve care for patients with chronic diseases and risk factors; these are added to usual care and are typically delivered by a team.

Enhancing the quality of health services – introduction to a new planning guide for implementers

Planning for quality is required at the national, district and facility-levels to enhance quality of care, and drive efforts towards universal health coverage. WHO recently launched Quality Health Services: a planning guide to support key actions required to improve the quality of health services for the entire population, recognizing the unique pathway for each country. The planning guide focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It is intended to support those working at all levels of the health system translate intention into results, delivering an impact on the quality of services for people across the world.

This 60-minute session will provide an overview of the WHO Quality Health Services: a planning guide, discussing how it can be applied to improve the quality of care across the health system.

Evaluation is Key: Providing Appropriate Evaluation Measures for Participatory and User-Centred Design Processes of Healthcare IT

The increasing availability of healthcare IT has the potential to improve the integration of health services. Existing projects developing healthcare IT mostly disregard the potential and importance of incorporating user feedback and proper evaluation measures to gain user feedback throughout the development process.

This article aims to provide methodological guidance for evaluation in a stepwise user-centred design process.

Integrated Care’s New Protagonist: The Expanding Role of Digital Health

Digital health technologies hold significant promise to advance both functional and normative health and social care integration. The COVID-19 pandemic has created a window of opportunity to rapidly advance the adoption of digital solutions which can improve activities that support integration at clinical, professional, organizational and system levels. Global examples demonstrate how the pandemic has also created opportunities to use technology to address core values of integrated care like person-centredness and coordination. However, rapid and reactive changes could lead to increased fragmentation and exacerbate health inequity. This perspective paper outlines some of the opportunities and threats to advancing integrated care presented by the rapid adoption of digital health tools, suggesting we maintain a long view to ensure the stage we set today will mean greater integration tomorrow.

The Advantages and Disadvantages of Integrated Care Implementation in Central and Eastern Europe – Perspective from 9 CEE Countries

Health and social care systems in Central and Eastern European (CEE) countries have undergone significant changes and are currently dealing with serious problems of system disintegration, coordination and a lack of control over the market environment. The increased health needs related to the ageing society and epidemiological patterns in these countries also require funding needs to increase, rationing to be reformed, sectors to be integrated (the managed care approach), and an analytical information base to be developed if supervision of new technological approaches is to improve. 

Lessons in the Design and Initial Implementation of the System on Prevention, Early Identification, Referral, and Intervention for Delays, Disorders, and Disabilities in Early Childhood in the Philippines

Approximately 1 in every 10 children has a disability and in developing countries, fewer than one out of 10 of them go to school (1) (2). Persons with disabilities experience overlapping deprivations that contribute to marginalization, significant discrimination, and ultimately, exclusion in societal participation, perpetrating the vicious cycle of disability and poverty (3) (4).

Early childhood is the time when the impact of disability into adulthood can be maximally mitigated. It is, therefore, crucial for identification to be carried out at the earliest possible instance and appropriate intervention is provided.

In the Philippines, efforts are underway to implement a system on prevention, early identification, referral, and intervention for delays, disorders, and disabilities in early childhood in select subnational areas. This is a project that is being implemented through the national Early Childhood Care and Development Council and the Department of Health with support from UNICEF and Humanity and Inclusion.

Important ...

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement.

How to implement person-centred care and support for dementia in outpatient and home/community settings: Scoping review

Little prior research focused on person-centred care and support (PCCS) for dementia in home, community or outpatient care. We aimed to describe what constitutes PCCS, how to implement it, and considerations for women who comprise the majority of affected persons (with dementia, carers). Despite the paucity of research on PCCS for dementia, synthesis of knowledge from diverse studies into a Framework provides interim guidance for those planning or evaluating dementia services in outpatient, home or community settings. Further research is needed to elaborate the Framework, evaluate PCCS for dementia, explore determinants, and develop strategies to implement and scale-up PCCS approaches. Such studies should explore how to tailor PCCS needs and preferences based on input from persons with dementia, and by sex/gender and other intersectional factors such as ethnicity or culture.

Enhancing inter-organisational partnerships in integrated care models for older adults: a multiple case study

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

Development and Implementation of an Integrated Care Fellowship

Integrated care is a common approach to leverage scarce psychiatric resources to deliver mental health care in primary care settings. The Integrated Care clinical fellowship serves as a model for training programs seeking to provide training in clinical and systems-based skills needed for practicing integrated care. Whether such training is undertaken as a standalone fellowship or incorporated into existing consultation-liaison psychiatry programs, such skills are increasingly valuable as integrated care becomes commonplace in practice.  

Prioritization of implementation barriers related to integrated care models in Central and Eastern European countries

The importance of integrated care will increase in future health systems due to aging populations and patients with chronic multimorbidity, however, such complex healthcare interventions are often developed and implemented in higher income countries. For Central and Eastern European (CEE) countries it is important to investigate which integrated care models are transferable to their setting and facilitate the implementation of relevant models by identifying barriers to their implementation. This study investigates the relative importance of integrated care models and the most critical barriers for their implementation in CEE countries. Experts from Croatia, Hungary, Poland, Romania and Serbia were invited to complete an online survey within the SELFIE H2020 project. 81 respondents completed the survey. Although experts indicated that some integrated care models were already being implemented in CEE countries, the survey revealed a great need for further improvement in the integration of care, especially the managed care of oncology patients ...

A comparison of three organisational levels in one health care region in Sweden implementing person-centred care: coupled, decoupled or recoupled in a complex organisation

Establishing more substantial patient involvement in the health care has become fundamental to Western health care services. Person-centred care (PCC) has been developed as a way of working that involve the patients and family members. However, the implementation of PCC in clinical practice has proven to be challenging. The aim of this study was to explore the congruence of managers’ perceptions and understanding of various aspects of PCC across three organisational levels in one health care region in Sweden in terms of coupling, decoupling and recoupling.

Facilitators and barriers to professional nurses implementing integrated services in urban primary health care clinics in Kavango East region, Namibia

The World Health Organization (WHO) has advocated for the implementation of people-centred and integrated health services. Although there is growing evidence of integration’s benefits for sexual and reproductive health, human immunodeficiency virus (HIV) and rights, health services face tremendous resource constraints when it comes to integrating these services.

Does Integrated Care Carry the Gene of Bureaucracy? Lessons from the Case of Québec

Demographic and epidemiological transitions of industralized countries mean health systems have to integrate health and social services to respond to the changing needs of their populations. Efforts to integrate care involve important policy and structural changes. This paper examines whether integration efforts are lost in translation during the bureaucratic appropriation of models, or, in an allegorical way, do they reveal genes of bureaucracy?

Successful ingredients of effective Collaborative Care programs in low- and middle-income countries: A rapid review

Integrating mental health care in primary healthcare settings is a compelling strategy to address the mental health treatment gap in low- and middle-income countries (LMICs). Collaborative Care is the integrated care model with the most evidence supporting its effectiveness, but most research has been conducted in high-income countries. Efforts to implement this complex multi- component model at scale in LMICs will be enhanced by understanding the model components that have been effective in LMIC settings. Following Cochrane Rapid Reviews Methods Group recommendations, we conducted a rapid review to identify studies of the effectiveness of Collab- orative Care for priority adult mental disorders of mhGAP (mood and anxiety disorders, psychosis, substance use disorders and epilepsy) in outpatient medical settings in LMICs. Article screening and data extraction were performed using Covidence software. Data extraction by two authors utilized a checklist of key components of effective interventi ns. Information was aggregated to examine ...

Experiences of implementing the 'Making Every Contact Count' initiative into a UK integrated care system: an interview study

The 'Making Every Contact Count' (MECC) approach is in line with the current National Health Service (NHS) strategy to improve and prevent health conditions in England. Despite its importance and value for preventative healthcare, implementation of MECC varies. The aim of this study was to explore the barriers and facilitators of implementing MECC and MECC training into an integrated care system (ICS).