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Comparative case studies in integrated care implementation from across the globe: a quest for action

Comparative case studies in integrated care implementation from across the globe: a quest for action
Comparative case studies in integrated care implementation from across the globe: a quest for action
Background: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems.

Methods: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework.

Results: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation.

Conclusions: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation
1472-6963
1-12
Stadnick, Nicole A.
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Sadler, Euan
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Sandall, Jane
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Fernandez Turienzo, Cristina
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Bennett, Ian M.
e5b9c242-8c0c-4e9d-b979-f38a698ab909
Borkan, Jeffrey
1c196d67-37f7-498d-aa17-11f8dc23d6dc
Oladeji, Bibilola
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Gureje, Oye
4ac63f7a-0c26-45fa-8f0f-35ad50aef892
Aarons, Gregory A.
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Sklar, Marisa
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Stadnick, Nicole A.
6225689e-669d-4dec-bade-16250089a8ff
Sadler, Euan
e5891abe-c97b-4e74-b9b3-6d7c43435360
Sandall, Jane
f77434d0-2a96-4815-bd7e-e4d95595f093
Fernandez Turienzo, Cristina
0eb42de8-9c55-45fd-a36b-8f329f84b402
Bennett, Ian M.
e5b9c242-8c0c-4e9d-b979-f38a698ab909
Borkan, Jeffrey
1c196d67-37f7-498d-aa17-11f8dc23d6dc
Oladeji, Bibilola
a9996bbd-27f6-45e2-a1b9-fdf9d6060895
Gureje, Oye
4ac63f7a-0c26-45fa-8f0f-35ad50aef892
Aarons, Gregory A.
50890e3a-c0c7-45c8-9bde-7a21c1a23718
Sklar, Marisa
d2bb5418-291a-445a-9b64-a201187f1638

Stadnick, Nicole A., Sadler, Euan, Sandall, Jane, Fernandez Turienzo, Cristina, Bennett, Ian M., Borkan, Jeffrey, Oladeji, Bibilola, Gureje, Oye, Aarons, Gregory A. and Sklar, Marisa (2019) Comparative case studies in integrated care implementation from across the globe: a quest for action. BMC Health Services Research, 19 (1), 1-12, [899]. (doi:10.1186/s12913-019-4661-5).

Record type: Article

Abstract

Background: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems.

Methods: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework.

Results: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation.

Conclusions: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation

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More information

Accepted/In Press date: 21 October 2019
e-pub ahead of print date: 27 November 2019
Published date: 2019

Identifiers

Local EPrints ID: 435219
URI: http://eprints.soton.ac.uk/id/eprint/435219
ISSN: 1472-6963
PURE UUID: b0130752-2854-45f4-af9b-094857156b96
ORCID for Euan Sadler: ORCID iD orcid.org/0000-0003-3827-224X

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Date deposited: 28 Oct 2019 17:30
Last modified: 17 Mar 2024 03:56

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Contributors

Author: Nicole A. Stadnick
Author: Euan Sadler ORCID iD
Author: Jane Sandall
Author: Cristina Fernandez Turienzo
Author: Ian M. Bennett
Author: Jeffrey Borkan
Author: Bibilola Oladeji
Author: Oye Gureje
Author: Gregory A. Aarons
Author: Marisa Sklar

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