the development model for integrated care applied in ... vat... · development model for integrated...
TRANSCRIPT
A self-evaluation tool for integrated care: the
Development Model for Integrated Care
applied in practice
Dr. Mirella Minkman & Msc. Lidewij Vat
INIC Conference
San Marino, March 30, 2012
What do we see in the Netherlands?
• Agenda: a need for integrated care
• Development: grow of initiatives across sectors
• Implementation: lots of projects and activities
• But: unclear what essential activities are, where to
start? How to improve?
• What can guide development?
• Needs: tools, knowledge of development of integrated
care, framework or model to guide
(Research) questions
Where to start and how to proceed? Practical models/ frameworks?
Which interventions are essential? Related to each other?
How can integrated care development be characterized?
Phd Research
Practice: case studies
• 23 case studies stroke care (improvement program)
• 8 dementia networks (case management)
Literature
• Literature review quality management models CCM and EFQM/MBQA
• A generic model for integrated care is missing
Model development and validation
• Delphi study, Concept Mapping, questionnaires
• Validation study in 84 integrated care services
Cluster
Result management (16)
• making results
transparent
• indicators
• aims and targets
• successes, (almost)
failures
• improvement
Diabetes network…
Multidisciplinary expert team…
Auditing team….
Indicators
Cluster
Integrated care
commitment (11)
• mutual commitment
• ambitions
• dependencies
• contract
• engaged leaders
• domains and trust
Diabetes network…
Signed contract…
Commitment with aims and ambition Synchroon..
4 Phases of development
1. Initiative and design phase
Exploring possibilities and chances, project design, agreements
2. Experimental and execution phase
Defining aims and content, coordination care chain, experiments
3. Expansion and monitoring phase
Further development and maturity, monitoring, new questions
4. Consolidation and transformation phase
Continues improvement, new ambitions, integrated structures
Use of the DMIC model
• Self-evaluation, guiding and steering, indicators
on process- and organisation level, monitoring
development over years, framework for further
research on integrated care, purchasing ic
• Integrated care services that have used the
model:
– Stroke, Acute Myocardial Infarction, Dementia
– Autism, youth care, palliative care, diabetes
DMIC as a self-evaluation tool
Insight in improvement opportunities
and more focused development
Insight in experiences and ideas of
integrated care partners
Comparing with others (benchmarking)
or over years
Web-based self-evaluation tool (one, or multiple
persons)
Preparation and personal accounts
Example diabetes: general practitioner, nurse,
specialist, dietist, manager, client federation
Lessons learned
• DMIC helped services with a more objective focus on
their integrated care activities.
• They used the results for their annual (improvement)
plan, quality management, as input for conversations
with partners about the development of their service…
• DMIC is generic: can be used for multiple types of
integrated care services.
• Next steps: more integrated care services,
international validation, research between the
organisation of integrated care and its results.
• Interesting for an international audience?
Literature
• Minkman, M (2011). Developing integrated care. Towards a development model for integrated
care. Thesis. Kluwer, Deventer. ISBN 978-90-13-10026-6.
• Minkman, M.M.N., Ahaus, K.T.B. & Huijsman, R. (2007). Performance improvement based on
integrated quality management models: what evidence do we have? A systematic literature
review. International Journal for Quality in Health Care, 19(2), 90-104.
• Minkman, M.M.N., Ahaus, K.T.B., Fabbricotti, I.N., Nabitz, U.W. & Huijsman, R. (2007). A
quality management model for integrated care: results from a Delphi and concept mapping
study. International Journal for Quality in Health Care 21 (2009a), nr.1, 66-75.
• Minkman, M.M.N., Ahaus, K.T.B. & Huijsman, R. (2009b). A four phase development model for
integrated care services in the Netherlands. BMC Health Services Research 9(42).
• Minkman M, Ahaus K, Huijsman R (2009). Modellen voor Ketenkwaliteit. In: Ketenzorg, Praktijk
in perspektief, H26, p277-291.
• Minkman, M.M.N., Ahaus, K.T.B. & Huijsman, R. (2011). The empirical validation of the
Development Model for Integrated Care. BMC Health Services Research.
• Minkman M, Ahaus K, Huijsman R (2010). Het Ontwikkelingsmodel voor Ketenzorg. In: M&O, nr5
sept, p26-43.
• De Eerstelijns (2011/2012): Diabetes pilot Synchroon en interview met Lidewij Vat en Mirella
Minkman.
• New 2012 (in Dutch): Essay in TSG, publication in Zorgmarkt, Kwaliteit in Zorg
Contact
Vilans, National Center of Expertise in long term
care. Utrecht, the Netherlands
• Lidewij Vat, Msc
[email protected] / Mob. +31-6-22810670
• Mirella Minkman, dr
[email protected] / Mob. +31-6-12285416