Table 4.
Element | Interventions shown to be effective | n = *[references] |
---|---|---|
1. Joint planning |
Joint strategic needs assessment agreed; formalising relationships between stakeholders; joint boards; promotion of a community focus and organisational autonomy; guide for collective decision making; multi-level partnerships; focus on continuum of care with input from providers and users. |
18 |
[13,16-18,25,26,28-37,39,40] | ||
2. Integrated information communication technology |
Systems designed to support shared clinical exchange i.e. Shared Electronic Health Record; a tool for systems integration linking clinical processes, outcomes and financial measures. |
17 |
[13,16,17,24,25,27-30,32-37,39,40] | ||
3. Change management |
Managed locally; committed resources; strategies to manage change and align organisational cultural values; executive and clinical leadership; vision; commitment at meso and micro levels. |
17 |
[13,16-18,24,25,28-30,32-36,38-40] | ||
4. Shared clinical priorities |
Agreed target areas for redesign; role of multi-disciplinary clinical networks/clinical panels; pathways across the continuum. |
16 |
[13,16-18,24,25,27,29,30,32-36,39,40] | ||
5. Incentives |
Incentives are provided to strengthen care co-ordination e.g. pooling multiple funding streams and incentive structures, such as equitable funding distribution; incentives for innovative and development of alternative models. |
15 |
[13,16,17,24,26,28-30,32,35-40] | ||
6. Population focus |
Geographical population health focus. |
13 |
[13,16,24-26,29,30,34-36,38-40] | ||
7. Measurement – using data as quality improvement tool |
Shared population clinical data to use for planning, measurement of utilisation focusing on quality improvement and redesign; collaborative approach to measuring performance provides transparency across organisational boundaries. |
12 |
[13,17,18,24,28,29,33-36,38,39] | ||
8. Continuing professional development supporting the value of joint working |
Inter-professional and inter-organisational learning opportunities provide training to support new way and align cultures; clearly identifying roles and responsibilities and guidelines across the continuum. |
11 |
[13,18,24,25,29,32-34,37,39,40] | ||
9. Patient/community engagement |
Involve patient and community participation by use of patient narratives of experience and wider community engagement. |
8 |
[13,18,25,29,35,36,39,40] | ||
10. Innovation | Resources are available and innovative models of care are supported. | 7 |
[13,18,29,33,34,36,40] |
*Number of studies reporting the specified element.