Improving integrated care for older people living at home in Europe: findings and experiences from the SUSTAIN project

摘要

Background : Numerous integrated care initiatives have been rolled out in a wide range of settings and contexts, in order to improve care and support for frail older people living at home. Despite this rich and varied field of practical examples, evidence on the effectiveness of integrated care remains inconsistent and knowledge on successful implementation and transferability of experiences to other contexts is still limited. To take a step forward in the development of integrated care, the cross-European research project called SUSTAIN was initiated in 2015, with a two-fold objective: 1. to support and monitor improvements to established integrated care initiatives for older people living at home, and 2. to identify improvements that could be applicable and adaptable to other health and social care systems and regions in Europe. Over the past two years, local stakeholders from thirteen existing integrated care initiatives in seven European countries have worked together with SUSTAIN project partners to improve their current way of working. Supported by SUSTAIN project partners, stakeholders from the different initiatives (i.e. managers, health and social care professionals, representatives of older people and informal carers, local policy officers) designed and implemented improvement plans tailored to local priorities. Using a multiple case study design, SUSTAIN project partners monitored and evaluated experiences and outcomes related to the design and implementation of these improvements in each initiative (or ‘case’). Comparing and integrating data from these different cases provides insight into what works for whom and in which context. Aims and objectives : During this workshop, we will share lessons learned so far from the implementation and evaluation of the improvement projects in the SUSTAIN project. The aim of the workshop is threefold: 1. inform the audience about the objectives and design of the SUSTAIN project, 2. illustrate outcomes and experiences related to designing and implementing improvements in three of the participating integrated care initiatives, and 3. present preliminary findings from the integration of outcomes and experiences of all participating initiatives. Format : During the first presentation, we will briefly show SUSTAIN’s overall structure, approach and activities to generate evidence on improving integrated care. During the second, third and fourth presentation we will share experiences from participating integrated care initiatives located in West-Friesland (the Netherlands), the Arnhem region (the Netherlands) and Sabadell (Spain). The fifth presentation will focus on preliminary findings based on overarching analyses of experiences from all initiatives. After the presentations, we will discuss with the audience how lessons learned during the SUSTAIN project can bring the development of integrated care further. Target audience : This workshop is targeted at researchers and decision-makers who want to know more about improving established integrated care initiatives. Learnings : After this session, participants will have insight in: 1. the objectives and design of the SUSTAIN project, 2. case-specific experiences and outcomes related to improving integrated care, and 3. preliminary outcomes of the overarching analyses which supports the understanding of what works for whom, in which context and with what outcomes.?evidence triangulation; frail older people; improvement projects; implementation science; cross-European research