Formative Evaluation of the Central Coast Integrated Care Program (CCICP), NSW Australia

Hazel Dalton,Sarah Bradfield,Angela Booth,Taryn Gazzard,Nick Goodwin,Kate Davies,David Perkins,Michael Bishop,Peter Lewis,Donna M Y Read,Sarah Wilcox,Anthony Critchley,Rachael Sheather-Reid,Anne Hendry,Tonelle Handley

doi:10.5334/ijic.4633

Abstract

Introduction:Integrated care has been posited as an important strategy for overcoming service fragmentation problems and achieving the Quadruple Aim of health care. This paper describes the Central Coast Integrative Care Program (CCICP) a complex, multi-component intervention addressing 3 target populations and more than 40 sub-projects of different scale, priority and maturity. Details are provided of the implementation including activities undertaken for each target population, in the context of the Central Coast Local Health District (CCLHD) strategies and priorities. Key lessons are drawn from the formative evaluation.Methods:A mixed methods approach to the formative evaluation was taken. Key stakeholders, professional staff with an in-depth knowledge of the program, were invited to complete surveys (n = 27) and semi-structured interviews (n = 23). The evaluation employed co-design principles with dialogue between CCICP partners and researchers throughout the process and sought to achieve a shared understanding of the dynamic context of the program, and the barriers and enablers for the various interventions.Key lessons and conclusion:Seven interdependent key lessons have been identified. These distil down to the setting of clear objectives aligning with all the goals of partners, developing strong relationships, leadership at multiple levels and communication and the building of a common language.

Highlights

Integrated care has been posited as an important strategy for overcoming service fragmentation problems and achieving the Quadruple Aim of health care
The purpose of this paper is to describe the formative evaluation of the Central Coast Integrative Care Program (CCICP), provide details on the implementation of program activities, including activities undertaken in each target group, in the context of Coast Local Health District (CCLHD) strategies and priorities
We have described the activities of the Central Coast Integrated Care Program

Summary

Introduction

Integrated care has been posited as an important strategy for overcoming service fragmentation problems and achieving the Quadruple Aim of health care. Details are provided of the implementation including activities undertaken for each target population, in the context of the Central Coast Local Health District (CCLHD) strategies and priorities. Services are delivered by multiple public and private providers, funded through a mix of federal and state governments and private entities with discrete goals and responsibilities. The NSW state government funds Local Health Districts (LHDs) to deliver secondary and tertiary health care services in community and hospital settings. Fee-for-service (market subsidy) arrangements operate in Australia, which reward the quantity of services rather than quality These funding arrangements tend to overlook population health needs and discourage collaboration to meet user needs and achieve health outcomes. Perverse incentives apply which may result in unintended penalties for good practice [2]

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Conclusion