Predicting and testing a silo-free delivery system

Abstract

Given the scale and complexity of the challenge of addressing the aging population, increasing demand for complex and integrated care, this article sets out potential opportunities to predict a future without silos, based on international learnings. Examining another country's health and delivery systems, it is interesting to see the similarities and differences, so we offer some reflections applicable to Canada. These models are breaking down the silos. Imagine a setting where you could collaboratively co-design scenarios, debate, refine policy, and predict future population needs. Using a transformation lab setting, governments and policy-makers, providers, patients, families, and community support groups could collaboratively take the time to learn new ways of working together in a risk-free environment before becoming accountable for delivering targeted outcomes. It is time to implement provincial transformation labs to test local strategies and operational plans to co-design scenarios, use simulation, and test the choices using evidence-based tools.

Key stakeholder experiences of an integrated healthcare pilot in Australia: a thematic analysis

“…Patient centred approaches are important in joining up health care and can reduce hospital admissions and costs [ 43 , 44 ]. Facilitators of patient-centredness identified in other settings such as better communication across sectors [ 45 , 46 ] and with patients [ 6 ], enhanced multidisciplinary collaboration [ 47 , 48 ] and a focus on prevention and patient self-management [ 49 , 50 ], were identified by our participants as key priorities of the WSICP. All participant groups valued the personalised focus of WSICP and particularly the access to holistic care early in the illness trajectory facilitated through the RASS clinics.…”

Key stakeholder experiences of an integrated healthcare pilot in Australia: A thematic analysis

“…Patient centred approaches are important in joining up health care and can reduce hospital admissions and costs (43,44). Facilitators of patient-centredness identi ed in other settings such as better communication across sectors (45,46) and with patients (6), enhanced multidisciplinary collaboration (47, 48) and a focus on prevention and patient self-management (49, 50), were identi ed by our participants as key priorities of the WSICP. All participant groups valued the personalised focus of WSICP and particularly the access to holistic care early in the illness trajectory facilitated through the RASS clinics.…”

Indigenous model of care to health and social care workforce planning

“…[21][22][23] Addressing these chronic health problems has become and will remain a dominant focus of the health and social care systems for the foreseeable future. 4,[14][15][16][17]23 As demonstrated in previous articles by this author, 24,25 scenarios and simulations are invaluable tools for creating viable and sustainable health and social care models. As Indigenous Peoples develop future state models of care, factors that significantly influence their health and social care service requirements must be considered.…”

“…Publications that address the need to change existing models of care to improve patient care (eg, achieve integration of service delivery) are prevalent in the academic literature. [24][25][26][27][28] There is little literature on using a "models of care" approach combined with scenario generation and simulation modelling. England, Australia, and New Zealand are using this approach to address economic pressures, identify areas for increasing specialization, and test the impact of new service and delivery models enabled by technology solutions and the implication on future resources.…”

“…In the same way, the processes and methods proposed in this article are interactive and based around the notion that developing "models of care" and strategic workforce planning is an iterative, collaborative process. 24,25,28 The concept of outcomes management is introduced as an alternative to the current model of strategic workforce planning. [29][30][31][32] Designed to stimulate discussion on a unique approach to creating "models of care" that meets future Indigenous health needs, this model also highlights impact on the workforce.…”