Towards Integrated Care for Chronic Patients in Belgium: The Pilot Project, an Instrument Supporting the Emergence of Collaborative Networks

Abstract

In 2015, the Belgian Health Ministers launched a plan intended to evolve towards an integrated care system for chronic patients. This plan is implemented through pilot projects involving local actors. Therefore, the researcher raised the following research question: how does the use of pilot projects as implementation instruments structure the collaboration between parties involved in a pilot project? The term “pilot project” refers to a collaborative work method coupled with an experimentation purpose. This is further developed in the paper via a literature study. This qualitative research draws on interviews, focus groups, direct observation, and a documentary analysis. During the two first phases of the process, field workers had to create multidisciplinary local consortia and write an application file describing the project they would implement during the third phase, which raised challenging collaboration issues. Many people learned to work together over time, progressively overcoming the traditional fragmentation of care. They met regularly, understood their respective roles, and dealt with controversies through negotiation to reach an agreement on a common project. In conclusion, the researcher shows that, thanks to its characteristics, the pilot project instrument supports the development of collaborative care networks; in this example of community-based integrated care networks.

Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium

“…Twelve ICPs were designated in this plan. These ICPs are instruments to create community-based networks [32]. ICPs are both large-scale implementation projects and test cases for future scaling-up to the entire country.…”

Developing evaluation capacities in integrated care projects: Lessons from a scientific support mission implemented in Belgium

“…Yet, how to concretely develop integrated care “in the Belgian-specific context was more uncertain. This explains why the Belgian authorities decided to use pilot projects as implementation instruments” ( 21 ). Using pilot projects is one way to involve diverse care providers and services in the development of integrated care reforms, without imposing a “one size fits all” solution.…”