Evaluation of the Implementation of PRISMA, a Coordination‐Type Integrated Service Delivery System for Frail Older People in Québec

Abstract

PRISMA is the only example of a co‐ordinated‐type model to be developed and fully implemented with a process and outcome evaluation. The PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and an implementation evaluation was carried out using mixed (qualitative and quantitative) methods. Over four years, the implementation rates went from 22% to 79%. The perception of integration by managers and clinicians working in the various organisations of the network shows that most interactions are perceived as at the co‐operation level, some getting the highest collaboration level. The perception of the efficacy of case managers was very high. Implementing such a model is feasible, and the decision to generalise it was made in Quebec. This model might be more appropriate for a universal publicly funded health care system like those in Canada, the UK and the Scandinavian countries.