Monitoring the Progress of System Integration

Lukas, Carol VanDeusen; Meterko, Mark; Lowcock, Susan; Donaldson-Parlier, Renee; Blakely, Michelle L.; Davies, Martin; Petzel, Robert A.

doi:10.1097/00019514-200210020-00004

Cited by 26 publications

(14 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found 12 instruments; ten questionnaires target patients, practitioners, managers/leaders, and staff [14141142143144145146147148149]. Two instruments [1150] use a set of indicators to measure the degree of implementation of integration components.…”

Section: Resultsmentioning

confidence: 99%

“…Continued progress towards integrated care will depend much on our ability to contrast and compare the impact of strategies across different levels and context. However, the complex interplay of structures, processes and outcomes of integrated care is difficult to disentangle, hampering evaluation of progress [1314]. Besides conceptual ambiguity, measuring integrated care is challenging because of a lack of tools to measure different aspects of integration and inherent difficulties in tracking down existing tools within a dispersed body of literature [1516].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Suter¹,

Oelke²,

Lima³

et al. 2017

Int J Integr Care

View full text Add to dashboard Cite

Background:Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care.Methods:We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools.Findings:From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains.Discussion:Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, “overall integration” tools may be useful for a broad assessment of the overall state of a system.Conclusions:Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Suter¹,

Oelke²,

Lima³

et al. 2017

Int J Integr Care

View full text Add to dashboard Cite

show abstract

“…In Miller’s [42] causal model of organizational performance and change, leadership plays a central role in positively or negatively impacting the interactions amongst individual performance, organizational performance and organizational culture. The model used by the US’ Veterans’ Affairs Upper Midwest Health Care Network, a publicly funded integrated system, links structures and processes with system level integration and performance [43]. The relational systems change model [44] is premised on the theory that supportive organizations that manage change and encourage and facilitate people to develop, grow, and change within the context of their relationships with others can effect system change.…”

Section: Resultsmentioning

confidence: 99%

“…In Canada, the Sisters of Charity of Ottawa Health Services used a balanced scorecard approach to align strategy and performance in long-term care [71], Pink et al [72] discuss the creation of a balanced scorecard for Ontario’s hospital systems, and the London Health Sciences Centre developed a balanced scorecard to evaluate an integrated dialysis delivery network [73]. In the US both the Mayo Clinic [74] and Veteran’s Affairs Upper Midwest Health Care Network [43] have implemented a balanced scorecard tool. Duke University Health System applied the balanced scorecard to its birthing centre [75] and Bilkhu-Thompson [76] reports on the implementation of a balanced scorecard by an emergency medicine service line.…”

Section: Resultsmentioning

confidence: 99%

Health systems integration: state of the evidence

Armitage¹,

Suter²,

Oelke³

et al. 2009

Int J Integr Care

311

277

View full text Add to dashboard Cite

IntroductionIntegrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems.MethodsA systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources.ResultsDespite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging.Discussion and conclusionHealthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.

show abstract

“…Out of the 300 articles included in the study of Bautista et al [23] a total of seven articles were selected for our review [55626364656667]. From the narrative search, an additional number of four articles were retrieved.…”

Section: Resultsmentioning

confidence: 99%

An Instrument to Measure Maturity of Integrated Care: A First Validation Study

2018

View full text Add to dashboard Cite

Introduction:Lessons captured from interviews with 12 European regions are represented in a new instrument, the B3-Maturity Model (B3-MM). B3-MM aims to assess maturity along 12 dimensions reflecting the various aspects that need to be managed in order to deliver integrated care. The objective of the study was to test the content validity of B3-MM as part of SCIROCCO (Scaling Integrated Care into Context), a European Union funded project.Methods:A literature review was conducted to compare B3-MM’s 12 dimensions and their measurement scales with existing measures and instruments that focus on assessing the development of integrated care. Subsequently, a three-round survey conducted through a Delphi study with international experts in the field of integrated care was performed to test the relevance of: 1) the dimensions, 2) the maturity indicators and 3) the assessment scale used in B3-MM.Results:The 11 articles included in the literature review confirmed all the dimensions described in the original version of B3-MM. The Delphi study rounds resulted in various phrasing amendments of indicators and assessment scale. Full agreement among the experts on the relevance of the 12 B3-MM dimensions, their indicators, and assessment scale was reached after the third Delphi round.Conclusion and discussion:The B3-MM dimensions, maturity indicators and assessment scale showed satisfactory content validity. While the B3-MM is a unique instrument based on existing knowledge and experiences of regions in integrated care, further testing is needed to explore other measurement properties of B3-MM.

show abstract

Monitoring the Progress of System Integration

Cited by 26 publications

References 1 publication

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Health systems integration: state of the evidence

An Instrument to Measure Maturity of Integrated Care: A First Validation Study

Contact Info

Product

Resources

About