A scaling-up strategy supporting the expansion of integrated care: a study protocol

Abstract

Purpose To ensure that more people will benefit from integrated care initiatives, scaling-up of successful initiatives is the way forward. However, new challenges present themselves as knowledge on how to achieve successful large-scale implementation is scarce. The EU-funded project SCIROCCO uses a step-based scaling-up strategy to explore what to scale-up, and how to scale-up integrated care initiatives by matching the complementary strengths and weaknesses of five European regions involved in integrated care. The purpose of this paper is to describe a multi-method evaluation protocol designed to understand what factors influence the implementation of the SCIROCCO strategy to support the scaling-up of integrated care. Design/methodology/approach The first part of the protocol focuses on the assessment of the implementation fidelity of the SCIROCCO step-based strategy. The objective is to gain insight in whether the step-based strategy is implemented as it was designed to explore what works and does not work when implementing the scaling-up strategy. The second part concerns a realist evaluation to examine what it is about the SCIROCCO’s strategy that works for whom, why, how and in which circumstances when scaling-up integrated care. Findings The intended study will provide valuable information on the implementation of the scaling-up strategy which will help to explain for what specific reasons the implementation succeeds and will facilitate further improvement of project outcomes. Originality/value The expected insights could be useful to guide the development, implementation and evaluation of future scaling-up strategies to advance the change towards more sustainable health and care systems.

The transfer of knowledge on integrated care among five European regions: a qualitative multi-method study

“…To encourage knowledge transfer (KT) and scaling-up of innovative integrated care solutions, the SCaling Inte-gRated Care in COntext (SCIROCCO) project has tested and validated the SCIROCCO tool ('the tool'), which is argued to support the adoption of integrated care across Europe [5]. Using a step-based approach, the tool was developed and assessed in real life settings within the project.…”

Assessment of the implementation fidelity of a strategy to scale up integrated care in five European regions: a multimethod study

“…In this paper, we present findings about the extent to which 'the activities within the SCIROCCO project have been implemented in line with expectations and if, how, and how far relevant initiatives have been developed between 2016 and 2018'. 18 In this way, factors that facilitated the implementation and factors that were not conducive to the implementation of the strategy are revealed. These insights in the implementation and contextual conditions of the SCIROCCO strategy will provide lessons for those interested in SCIROCCO's step-based approach and future use of its tool and processes to reach progress in the integration of care services.…”

Assessing the maturity of the healthcare system for integrated care: testing measurement properties of the SCIROCCO tool

“…To further develop the B3-MM, The European Union (EU) Health Programme funded project SCIROCCO, aims to develop, test and validate the B3-MM to become a key tool in facilitating exchange of good practices and scaling-up of integrated care in Europe. The definition of scaling-up which is used in the context of the EIP on AHA, and the SCIROCCO project, is derived from the review of Mangham and Hanson, and is described as “the ambition or process of expanding the coverage of health interventions,” but can also refer to “increasing the financial, human and capital resources required to expand coverage [ 2 ].” The various steps involved in the SCIROCCO project including the details on the further development of B3-MM are described in a study protocol elsewhere [ 3 ].…”