Participatory Approaches to Improve Integrated Care Programs: Methods, Experiences, and Early Results Applying Methods from Implementation Research

Abstract

Background: Innovative process improvements in integrated care programs are increasingly implemented in daily practice by improving certain service elements e.g. safety, person-centeredness, or patient selection to achieve program sustainability and/or program upscaling. Because of the often complex nature of these initiatives, it is challenging to prove effectiveness. We use evidence-based methods from implementation research to monitor and to evaluate integrated care programs during process improvement actions, and to understand if and how implemented actions affect the program in an operational setting. In implementation research, it is important to consider all aspects of the implementation of the program, including the context in which it is being implemented, perspectives of all relevant stakeholders in particular the end users, as well as the organizational processes around the programs. Implementation research also promotes the systematic application of research findings in practice Peters et al 2013. The projects Advancing Care Coordination and Telehealth deployment at Scale ACT@Scale1, Sustainable Tailored Integrated Care for Older People in Europe SUSTAIN2, and DementiaNet3 all apply participatory approaches where local stakeholders design and implement local improvements. The projects all use cyclic improvement processes with the ambition to achieve rapid flow of evidence to practice and to disseminate knowledge and good practices at national and European level. The projects cover a wide variety of integrated care programs running in different settings, having different target populations e.g., chronically ill, multi-morbid, frail elderly, and mental health, and implement different improvement actions. Despite these differences, many common denominators exist, which will be elaborated in this session. Aims and objectives: The overall aim of this session is to provide an overview of implementation research methodologies and to provide examples how to implement and evaluate quality improvement actions in integrated care. Each project will present their experiences with and preliminary results of applying participatory approaches in clinical daily practice, covering different contexts and populations. Common denominators and differences will be discussed. In the discussion part, generalisability of these experiences for other European projects on integrated care will be highlighted. Format timing, speakers, discussion, group work, etc: During the session, the different participatory approaches applied in ACT@Scale, SUSTAIN and DementiaNet will be presented. The authors will further share their experiences applying the participatory approach, using concrete examples and results from actual program improvement actions. After the presentations, common lessons learned in the projects will be identified and discussed with the audience. Target Audience: This workshop targets all stakeholders from clinical management and researcher background who are involved or interested in integrated care improvement methods. Sharing of your own experiences in the open discussion is an integral part of this session. Learnings / Take away: After this session, participants will: 1. have insight in different implementation research approaches for improvement processes in integrated care; 2. will be informed about how to apply these methods and what the pros, cons, barriers and enablers are; and 3. Gain ideas on how to translate and apply lessons learned to their own practice.