How Can Patient Empowerment Be Integrated Into Change Management While Scaling-Up An Integrated Care Program?

Introduction : It is a challenge to ensure transferability of successful integrated care services to a new healthcare setting. The ACT@Scale program aims to identify, transfer and scale-up mature integrated care and telehealth practices in different regions in Europe. Patient empowerment PE, representing the process through which greater control over health is gained, is one of the target areas for successful integrated care deployment. In ACT@Scale, five integrated care programs, represented by a local multidisciplinary team, identified the key issues related to PE and required changes to improve the program in order to scale it up. Short description of practice change implemented : During the ACT@Scale project, programs apply collaborative methodologies CM to stimulate rapid process improvement. It encompasses routine data collection and assessment, provision of training material and communication channels. Regions develop and apply changes to improve the level of patient empowerment in their programs. Various surveys that measure PE level are used patient activation PAM[1]; psycho-social profile MAY[2]; program satisfaction NPS[3]; and staff attitude on PE CSPAM[2]. Aim and theory of change : Regions use CM to apply process improvements while learning cycles are managed by Plan-Do-Study-Act PDSA cycles. Evidence from the data is used to start subsequent improvement cycles. We monitor PE during the upscaling process. Targeted population and stakeholders : Implemented changes target patients of five integrated care programs, healthcare providers and program managers. Timeline : Total project duration is three years. Two full one-year PDSA cycles will be completed by participating programs. Highlights : The approach is complemented by an ICT solution for data collection and visualization to support decision-making. ICT data management allows distributed analysis of patient outcomes and resource utilization. This data remains in the regions, while a central engine runs remote analysis and displays aggregated results across regions. Comments on sustainability : The ACT@Scale program has a dedicated work package to address sustainability.Some participating programs are addressing this topic by applying changes in this area. Comments on transferability : Sharing of good practices within the consortium is part of collaborative methodology. During the final phase of ACT@Scale, specific local and international activities on dissemination and knowledge transferability will be organized. Conclusions : By using surveys, we can measure patient empowerment level in the program staff and patients and the regional level of adoption. Tools for monitoring progress of these levels and impact on outcomes during process improvement are essential to support the decision making process. Discussions : The data collection and regional implementation of the ICT technology are in progress. When completed, it will allow a more detailed analysis of patient empowerment levels into integrated care programs. Lessons learned : Distributed analysis can be a solution when data sharing is not allowed. References : 1- J. H. Hibbard et al., “Development and testing of a short form of the patient activation measure,” Health Serv. Res., 40 2005, 1918;1930 2- H. Schonenberg et al., “Evaluation Engine Architecture Architecture to analyse and monitor scaling-up for integrated care programs,” 2016. 3- F. F. Reichheld, “The One Number You Need to Grow,” Harv. Bus. Rev., 812003 46:54;124.