ANALYSIS AND DESIGN Case Study Work Session 2 From Concept to Reality International Summer School Integrated Care Pepper’s Salt Resort, Kingscliff, NSW, March 27th, 2018

The Implementation Model for Integrated Care Change Management Steps Relationship Building Activities Needs Assessment Establishing a guiding coalition Diagnosis Situational Analysis Building support for change Value Case Development Vison and mission statement Analysis and Design Feedback Loop Cycle of Learning Strategic plan Developing collaborative capacity Establishing mutual gain Communication Implementation Support Implementation and institutionalisation Monitoring and evaluation Evaluation Goodwin, 2015, 2017; Lewis and Goodwin, 2017

This Value Case An approach that attempts to understand the level of investment required, and the return on that investment Essential to release resources from funders Focus on ‘value’ created rather than costs contained – so focus on patient and staff experiences (inclusive of patient views) Establish ‘added value’ resulting from combing resources and expertise Establishes compelling case for change Examples and tools: Integrated care ‘value based tool-kit’ in England developed by the Local Government Association; Simulations and modelling; Xcelere8 & Collabor8 initiatives in Canterbury DHB, NZ Logic Models

Value Case: Using Logic Models Logic modelling, or programme logic, is an approach for representing the way a programme’s various components are expected to fit together to achieve its outcomes. Logic modelling has been one of the tools that has been used widely by localities in England for helping shape how they evaluate impact on outcomes. A logic model creates a diagrammatic representation of the key components of a programme and the way that actions are intended to lead to outcomes. The underlying emphasis on logic underlines the potential for a model of this type to challenge assumptions and prompt a reality check about whether or not the programme’s actions are adequate to achieve its intended outcomes.

Value Case: Use Logic! Logic modelling, or programme logic, is an approach for representing the way a programme’s various components are expected to fit together to achieve its outcomes. It is widely used, for example in England, to shape integrated care strategies The approach requires in-depth thinking about what outcomes are being sought, over what time-scale, for whose benefit, with what resources and investments. It crucially requests evidence behind the logic of why integrated care models might provide a solution Workforce INPUTS OUTPUTS WHOLE SYSTEM OUTCOMES Improving service user experience Achieving health and well being outcomes Using resources effectively Delivering person centred coordinated care through Patient experience Performance Finance Funding Facilities Technology Trained staff New care Models Co-location Data sharing BENEFITS Develop and deliver training ACTIVITIES Design operating model Coordinate the office move Implement new systems

Sample

Developing a Logic ‘Map’ what activities are required to achieve the outputs what you expect / intend the outcomes to be what off the peg resources are available. what improvements result from and are enabled by the outcomes. To create a logic map – be clear about: where you are starting from (context/baseline) how you intend to do deliver your work (inputs) what you expect / intend the outputs to be

Getting the logic right? Key tips https://midlandsandlancashirecsu.nhs.uk/news-insight/press-releases/236-using-logic-models

Group Work – Instructions 1 In your group: Examine the situational analysis that you undertook in the diagnosis phase INPUTS: Outline the list of resources that may be needed (e.g. staff, volunteers, equipment, technology, finances, ICT, infrastructure etc) OUTPUTS: What are the core outputs of these interventions – what do they influence? OUTCOMES: What are the changes we would expect as a result of these activities in the short-, medium- and long-term? What will improve in terms of care experiences, care outcomes, utilization of services and/or costs of care? Using flip-chart paper, construct a simple diagrammatical ‘logic model’ for your case scenario

Group Work: Instructions 2