PGLO undertook a multi-pronged initiative to develop a Performance Implementation and Measurement Framework to guide the design, implementation and measurement of a system of integrated care to support older persons living with complex health and social care requirements in Ontario and their care partners.
Project Deliverables: The Framework is comprised of the following distinct yet interconnected components:
- conceptual model
- systems-level logic model
- set of initial indicators
- analysis matrix
- implementation rubric
Each component represents a tool that can be used by multiple stakeholders for a variety of purposes relating to design, implementation and measurement. Together, the components form a comprehensive toolchest (i.e. conceptual, structural, operational) from which to empirically inform policy, administrative and practice decision-making to strengthen a system of integrated care, across the continuum of care for this priority population. The various components are described (i.e. how they were developed, how they are intended to be used) in the body of this document.
The development of the Framework (and its component parts) is informed by theories and models of integrated care, empirical evidence, and the perspectives of multiple stakeholders including the views and priorities of older persons and care partners. A whole-systems perspective was applied to this work, meaning that the interconnections between multiple levels of support (macro, meso, micro) are highlighted and discussed throughout.
This work provides a starting point, a comprehensive base from which to begin to strengthen a system of integrated care for older persons and care partners living with complex health and social care requirements. Its application in practice will help us better understand the synergistic nature of integrated care and how this feature impacts the design, implementation and measurement of integrated care initiatives. Given that health systems are in a state of transition, this is an ideal time to identify what ought to be put in place in coming years to meet the health and social care priorities of this population (Harnett et al. 2020; Flaherty & Bartels, 2019; De Bruin et al. 2018; WHO, 2016). This framework can guide us as we move forward, toward what ought to be.