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Shifting paradigms: Developmental milestones for integrated care.

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Summary

This study introduces a novel milestone framework for integrated care development, identifying 5 categories and 12 events. This strategy aids policymakers and leaders in accelerating integrated care implementation.

Keywords:
CanadaHealth policyHealth systemsImplementation scienceIntegrated delivery systemsIntegrated health care systemsNew Zealand

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Area of Science:

  • Health Services Research
  • Organizational Studies
  • Primary Health Care

Background:

  • Existing integrated care frameworks often overlook local contextual complexities.
  • Understanding the developmental trajectory of integrated care is crucial for effective implementation.

Purpose of the Study:

  • To propose a novel strategy for conceptualizing integrated care development through organizational milestones.
  • To present an empirically generated typology of these milestones from case studies.

Main Methods:

  • Analysis of 28 interviews with managers and leaders from four integrated community-based primary health care (ICBPHC) case studies in Canada and New Zealand.
  • Development of timelines and synthesis of themes to identify specific milestone events and categories.

Main Results:

  • A typology of 5 milestone categories (strategic relational, strategic process change, internal structural, inter-organizational structural, external) comprising 12 specific events was generated.
  • These milestones provide a framework for understanding the phased development of integrated care.

Conclusions:

  • A milestone-based framework offers a compelling strategy for conceptualizing integrated care development.
  • Policymakers and leaders can use this framework to identify strategies for accelerating integrated care implementation by examining local context and history.