“On the Margins and Not the Mainstream": Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of the population. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select "appropiate" cases to study. In this commentary, this study reflect the difficulty in identifying "successful" models to study, the value of drawing on clinical and organisational networks and experts, and the association between policy context and ease of case selection. Such insights have important implications for case study methodology in health services and policy research. 

A Realist Evaluation of Local Networks Designed to Achieve More Integrated Care

Not surprisingly given their multi-component nature, initiatives to improve integrated care often evolve to find the best way to bring about change. This paper provides an example of how an evaluation evolved alongside such an initiative designed to better integrate care across primary, community and hospital services in South Auckland, New Zealand.

Rethinking workforce planning for integrated care: using scenario analysis to facilitate policy development

A goal of health workforce planning is to have the most appropriate workforce available to meet prevailing needs. However, this is a difficult task when considering integrated care, as future workforces may require different numbers, roles and skill mixes than those at present. With this uncertainty and large variations in what constitutes integrated care, current health workforce policy and planning processes are poorly placed to respond. The scenario-based workforce shows that through applying techniques that have been developed to accommodate uncertainty, health workforce planning can benefit when confronting issues associated with integrated care.

Integrated ambulatory care in the New Zealand health system: a scoping review

Integrated health systems, according to the World Health Organization (2017) are ''the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money.'' This is a very important concept in today's day and age, as access to healthcare has become a challenge and the population has never been sicker.

In New Zealand and internationally, emerging trends across health systems include a fundamental shift of care from hospitals to community-based settings and increased integration of services to better link traditional community, primary and secondary/specialist. 

The aim of this review is to identify and describe New Zealand (NZ) and international countries evidence of integrated ambulatory care models and describes key implementation issues and lessons learned.

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.

Integrated Care in Aotearoa New Zealand 2008–2020

Ten years ago, progress towards integrated care in Aotearoa New Zealand was characterised as slow. Since then, there has been a patchwork of practices occurring under the broad umbrella of integrated care. These include: collective planning approaches (i.e., alliancing), agreed pathways of care, chronic care management initiatives, shared patient information systems, co-located centres and indigenous models of holistic care (e.g., Whanau Ora).