Dynamic sustainability of integrated health and social care and the importance of adaptive strategic management

Klinga, Charlotte; Hasson, Henna; Carlsson, Karin Solberg; Andreen-Sachs, Magna; Hansson, Johan

doi:10.5334/ijic.2623

Cited by 4 publications

(1 citation statement)

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“…However, reports regarding the utility of the DSF framework in studying the sustainability of public health interventions still remain limited. Although Klinga et al [18] reportedly used DSF in describing factors that contribute to the achievement of sustainable integration of health and social care for persons with complex needs in Sweden, details of lessons to be gleaned from this study are yet to be published.…”

Section: Introductionmentioning

confidence: 99%

Sustainability of public health interventions: where are the gaps?

Walugembe

Sibbald

Ber³

et al. 2019

Health Res Policy Sys

125

114

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The current scholarly focus on implementation science is meant to ensure that public health interventions are effectively embedded in their settings. Part of this conversation includes understanding how to support the sustainability of beneficial interventions so that limited resources are maximised, long-term public health outcomes are realised, community support is not lost, and ethical research standards are maintained. However, the concept of sustainability is confusing because of variations in terminology and a lack of agreed upon measurement frameworks, as well as methodological challenges. This commentary explores the challenges around the sustainability of public health interventions, with particular attention to definitions and frameworks like Normalization Process Theory and the Dynamic Sustainability Framework. We propose one important recommendation to direct attention to the sustainability of public health interventions, that is, the use of theoretically informed approaches to guide the design, development, implementation, evaluation and sustainability of public health interventions.

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Section: Introductionmentioning

confidence: 99%

Sustainability of public health interventions: where are the gaps?

Walugembe

Sibbald

Ber³

et al. 2019

Health Res Policy Sys

125

114

View full text Add to dashboard Cite

show abstract

Health and social care professionals’ experiences of collaborative planning—Applying the person‐centred practice framework

2020

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Person-centred care (PCC) is a concept that has become widely used (Ekman, Hedman, Swedberg, & Wallengren, 2015; McCance, McCormack, & Dewing, 2011) and is a central part of policies for delivering health care and social care. At the same time, there has been a shift from hospital-based care to home care and the way services are delivered. This includes providing integrated health care and social care around peoples' needs that are effectively coordinated across providers. The essence of PCC is a health system designed around individuals, families and community preferences, values and needs (World Health Organization, 2015). A requirement for delivering PCC is collaboration between healthcare and social care professionals. The collaboration acknowledges the unique expertise of various professionals and is essential for delivering high-quality patient care (Fox & Reeves, 2015). By focusing on PCC in practice, healthcare and social care organizations want to move from fragmented, paternalistic and disease-oriented care to relationship-based, collaborative and holistic care (McCance et al., 2011; Washburn & Grossman, 2017). However, many health systems are struggling with effective implementation of PCC (Santana et al., 2018). Studies have shown that barriers to the implementation of PCC are the traditional practices, structures, resources, time, skills and attitudes of pro

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Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care

Klinga

Hasson

Sachs

et al. 2018

BMC Health Serv Res

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BackgroundChange initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy.MethodsA retrospective and qualitative case-study research design was used, and data from the model organisation’s steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF).ResultsThe development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care.ConclusionThis study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users’ needs were essential in order to tailor services to the needs. Another major finding was the importance of continuously adapting the content of the change to suit its context. Hence, continuous refinement of the change content was found to be more important than designing the change at the pre-implementation stage.

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Dynamic sustainability of integrated health and social care and the importance of adaptive strategic management

Abstract: Dynamic sustainability of integrated health and social care and the importance of adaptive strategic management

Cited by 4 publications

References 0 publications

Sustainability of public health interventions: where are the gaps?

Sustainability of public health interventions: where are the gaps?

Health and social care professionals’ experiences of collaborative planning—Applying the person‐centred practice framework

Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care

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