Table 1.

Elements key to meso level organisations working together [36].

Element	Interventions shown to be effective
1. Joint planning	Working together agreements to support joint strategic focus for future work between stakeholders focusing on the continuum of care.
2. Integrated information communication technology	Systems designed to support shared clinical exchange, such as, Shared Electronic Health Record, and tools to support systems integration linking clinical processes, outcomes and financial measures.
3. Change management	Bilateral support for an agreed change process which is managed locally, and has demonstrated leadership, vision and commitment.
4. Shared clinical priorities	Target areas for redesign are agreed and multi-disciplinary pathways across the continuum supported.
5. Incentives	Funding mechanisms are provided to strengthen care co-ordination and there are incentives to innovative.
6. Population focus	Geographical population health focus.
7. Measurement – using data as quality improvement tool	Shared data is used for planning, measurement of utilisation focusing on quality improvement and redesign and a collaborative approach to measuring performance provides transparency across organisational boundaries.
8. Continuing professional development supporting the value of joint working	Inter-professional and inter-organisational learning opportunities provide training to support new ways of working and align cultures.
9. Patient/community engagement	Involve patients and communities in developing the outcome they want.
10. Innovation	Resources are available and innovative models of care are supported.