People-centred integrated care: co-designing standards - igniting a movement

Abstract

People-centred and evidence-based standards focused on system integration are quintessential to improving the quality of people’s care experiences and health outcomes. For example, by 2020, chronic conditions will account for almost three-quarters of all deaths worldwide. Individuals with chronic conditions require long-term, complex health and social services supports that optimize collaboration and coordination between care professionals and sectors. Integrated care means seamless care that is delivered and supported by a team of providers, that meets peoples’ needs over their lifetime. HSO’s Integrated People-Centred Health and Social Services (IPCHSS) standard is a co-designed, evidence-based tool that equips decision-makers with criteria and resources for planning, implementing and assessing the coordination of services and supports across the continuums of care. Health and social service decision makers around the world are challenged to design and deliver solutions that are sustainable and ensure accountabilities. This involves ensuring that appropriate, coordinated and comprehensive care is delivered based on priority high-need populations; and that resources are allocated in an equitable and ethical manner. Building the confidence of patients and families, that assures care is safe and of the highest quality, entails promoting a shared culture of people-centred care. Anchored on people-centered principles, HSO’s IPCHSS standard can be used by jurisdictions to engage and empower people, providers and communities; strengthen governance and accountability; and coordinate services within and across sectors to create an enabling and integrated environment. The IPCHSS standard is targeted to jurisdictions, including health and social ministries, administrators or authorities, who are accountable for funding, planning, coordinating, delivering and/or evaluating health and social services in their local communities. The standard will benefit people and populations with chronic conditions, noncommunicable diseases, mental health needs and multi-morbidities; and others whose care pathways require touch-points with providers from across the continuum of care. Applying co-design principles, processes and techniques to the IPCHSS standard allowed for a person-centered approach to identifying integrated care problems and solutions. The Technical Committee (TC), composed of experts including patients and caregivers (3), policy makers (4), providers (3), subject matter experts (4) and advisors (2), brought a rich diversity of values, approaches and experiences that surfaced lessons of knowledge power-sharing and valuable participatory design. Targeted stakeholder consultations, involving interviews with over thirty ministries, administrations, authorities, providers, patients and caregivers reinforced that integration is context driven and requires strength in the relationships, resources and priority alignment across health and social service ecosystems. The co-design process has been fundamental to ensuring the IPCHSS standard is transferable to the local context of health and social systems around the world. A movement towards integration can only be realized through engaging, mobilizing, inspiring, and empowering people, families, providers and communities. HSO’s co-design principles and processes were necessary to ensure that the IPCHSS standard is: 1) reflective of the expertise, experience and voice of those impacted and those who influence integrated care; and 2) responsive to the needs and priorities of the decision makers who are accountable to delivering quality care and supports to their communities.

Keywords

• person-centred
• integrated care
• standard
• co-design