Can a case lead approach deliver the "craft and graft" of integration?

Tools

Bailey, D. ORCID: 0000-0001-5823-7746 and Mutale, G.J. ORCID: 0000-0002-7743-2675, 2020. Can a case lead approach deliver the "craft and graft" of integration? Journal of Integrated Care. ISSN 1476-9018

Preview

Text
1353361_a820_Bailey.pdf - Post-print
Download (480kB) | Preview

Official URL: https://doi.org/10.1108/jica-11-2019-0046

Abstract

Purpose: The aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation.

Design/methodology/approach: The study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this.

Findings: The relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected.

Originality/value: The study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments.

Item Type:

Journal article

Publication Title:

Journal of Integrated Care

Creators:

Bailey, D. and Mutale, G.J.

Publisher:

Emerald

Date:

31 July 2020

ISSN:

1476-9018