Implementation, Mechanisms of Effect and Context of an Integrated Care Intervention for Vulnerable Families in Central Sydney Australia: A Research and Evaluation Protocol.

John G Eastwood,Roelof G A Ettema,Denise E De Souza,Pankaj Garg,Erin Miller,Susan Woolfenden,Miranda Shaw,Hueiming Liu

doi:10.5334/ijic.4217

Abstract

Introduction:In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation.Theory and Method:The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods.Discussion:The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.

Highlights

In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy
In March 2014, the New South Wales (NSW) State Government of Australia released the NSW Integrated Care Strategy to transform the delivery of care for patients, improve their health and wellbeing, and minimise costs associated with fragmentation of care delivery across the hospital and primary care sector
Electronic Medical Records (EMR) Data-Linkage Studies. This project aims to develop technical and analytical approaches to the use of routinely collected patient information to examine the impact of implemented integrated care initiatives on the early life experiences and the health, development and welfare of infants born in the Sydney Local Health District (SLHD)

Summary

Introduction

In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In March 2014, the New South Wales (NSW) State Government of Australia released the NSW Integrated Care Strategy to transform the delivery of care for patients, improve their health and wellbeing, and minimise costs associated with fragmentation of care delivery across the hospital and primary care sector This was to be achieved by: “a) focusing on organising care to meet the needs of targeted patients and their carers, rather than organising services around provider structures; b) designing better connected models of health [and social] care to leverage available service providers to meet the needs of our smaller rural communities; c) improving the flow of information between hospitals, specialists, community and primary care providers; d) developing new ways of working across State government agencies and with Commonwealth funded programs to deliver better outcomes for identified communities; and e) providing greater access to out-of-hospital community-based care, to ensure patients receive care in the right place for them” [1]. The personcentred intervention is supported by other components that function at professional and organisational levels (see Box1)

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