Table 4.

Crucial elements for phase transitions

Element	N = 30	N = 30	N = 8
	1- > 2	2- > 3	3 - > 4
Assuring the leadership commitment of the partners involved in the care chain	++	++	+
Allocating financial budgets for the implementation and maintenance of integrated care	++	++	+
Installing a coordinator working at chain-care level	+	++
Reaching agreements among care partners on tasks, responsibilities and authorizations	+	++
Developing a multi-disciplinary care-pathway	+	+
Offering case management for clients with complex needs	+	+
Defining the ambitions and aims of the collaboration in the care chain	+	++
Installing improvement teams at care chain level	+
Guiding the care chain by emphasizing a collaborative commitment	+
Achieving adjustments among care partners by means of direct contact		++
Creating an open environment that encourages experiments and pilot projects		++
Using a systematic procedure for the evaluation of agreements, approaches and results		+
Stimulating a learning culture and continuous improvement in the care chain		+

+: Element is named ≥ 3 times.

++: Element is named ≥5 times.

Empty cell: element is not named or <3 times.