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New Zealand's Integration-Based Policy for Driving Local Health System Improvement - Which Conditions Underpin More

Tim Tenbensel1, Pushkar Raj Silwal2, Lisa Walton2

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Strong local relationships are key for successful health system integration under New Zealand's System Level Framework (SLMF). Fidelity to the policy is necessary but not sufficient for achieving better health outcomes through integrated care.

Keywords:
New ZealandQualitative Comparative Analysisdata sharingimplementationinter-organisational collaboration

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Area of Science:

  • Health Services Research
  • Health Policy
  • Organizational Studies

Background:

  • New Zealand's Ministry of Health introduced the System Level Framework (SLMF) in 2016 to enhance health outcomes via local inter-organizational integration.
  • Understanding local-level conditions is crucial for the successful implementation of this integrated care policy.

Purpose of the Study:

  • To identify critical local-level conditions influencing the successful implementation of the SLMF policy.
  • To analyze the factors contributing to effective integrated care initiatives.

Main Methods:

  • Qualitative Comparative Analysis (QCA) was employed.
  • Data included 50 interviews with managers and clinicians involved in SLM implementation (2018) and SLM Improvement Plans from all districts over three years.

Main Results:

  • The strength of formal and informal organizational relationships at the local level emerged as critical for implementation success.
  • Fidelity to the SLMF policy was necessary but not sufficient.
  • Broader contextual factors like population size and organizational complexity were less significant.

Conclusions:

  • Implementation success was linked to 'Maturity of SLM Improvement Plan Processes' and 'Data Sophistication and Use'.
  • Integrated health system improvement necessitates collaborative, trust-based approaches with iterative learning and data sharing.
  • Focusing on establishing and strengthening collaborative governance is vital for integrated care.