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Integrated complex care model: lessons learned from inter-organizational partnership.

Eyal Cohen1, Cindy Bruce-Barrett, Shauna Kingsnorth

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Summary
This summary is machine-generated.

Developing integrated care for children with medical complexity in Canada is difficult. A tripartite partnership model improved care coordination for frequent service users, showing early success in client enrollment and funding acquisition.

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Area of Science:

  • Healthcare Management
  • Pediatric Care
  • Health Services Research

Background:

  • Children with medical complexity require coordinated care across multiple providers and organizations.
  • Existing healthcare systems often face challenges in delivering integrated services for these children.
  • Fragmented care can lead to suboptimal health outcomes and increased healthcare utilization.

Purpose of the Study:

  • To describe the development of an inter-organizational team for integrated care delivery.
  • To focus on children with medical complexity who frequently utilize services across acute care, rehabilitation, and home/community settings.
  • To emphasize model building and operationalization within the Canadian healthcare system.

Main Methods:

  • Formation of a tripartite partnership involving an acute care hospital, a children's rehabilitation hospital, and a home/community health organization.
  • Focus on children with high service utilization across these three organizations.
  • Emphasis on addressing communication and policy barriers within the Canadian healthcare context.

Main Results:

  • Successful development of an inter-organizational team model.
  • Identification of communication and policy barriers, alongside strategies for optimizing family interactions.
  • Early indicators of success include enrollment of 34 clients and patients.
  • Secured funding for evaluation and expansion of the integrated care model.

Conclusions:

  • Integrated care models are crucial for optimizing health outcomes in children with medical complexity.
  • Alignment with healthcare policy trends and inter-organizational commitment are critical enablers for integration.
  • Further policy development is needed to support full integration across service sectors.
  • The tripartite partnership model shows promise for improving care coordination and outcomes.