Duggal Sandhya, Miller Robin, Tanner Denise
University of Birmingham, Birmingham, UK.
Int J Integr Care. 2021 Nov 17;21(4):19. doi: 10.5334/ijic.5621. eCollection 2021 Oct-Dec.
To date, few studies have examined the implementation of asset-based integrated care in the UK. This paper aims to address this gap in knowledge through examining the implementation of one model of asset-based integrated care, Local Area Coordination (LAC), within two localities in England.
This paper draws upon data collected from two local authorities (site A and site B), which had both implemented LAC. Using a case study approach, qualitative data was collected from interviews with relevant stakeholders both internal and external to the local authorities. Data was analysed thematically.
The findings demonstrate the marked differences between the two sites' approaches to LAC, especially in relation to: the implementation process; impact; and their collaboration with other agencies and communities.
The evidence presented in this paper demonstrates that the implementation of LAC, as with most complex service innovations, is dependent on the interplay of organisational and people-based components. In particular, successful implementation depends on maintaining a common vision of what an intervention will achieve and how it will work in practice, continual engagement with the political and organisational leaders of influence, positively addressing the anxieties of existing services and professions, and working with community groups.
迄今为止,在英国很少有研究考察基于资产的综合护理的实施情况。本文旨在通过考察英格兰两个地区基于资产的综合护理模式之一——地区协调(LAC)的实施情况,来填补这一知识空白。
本文借鉴了从两个实施了LAC的地方当局(A地和B地)收集的数据。采用案例研究方法,通过对地方当局内部和外部相关利益攸关方的访谈收集定性数据。对数据进行了主题分析。
研究结果表明,两个地区在LAC实施方法上存在显著差异,特别是在以下方面:实施过程;影响;以及它们与其他机构和社区的合作。
本文所呈现的证据表明,与大多数复杂的服务创新一样,LAC的实施取决于组织和人员相关要素的相互作用。具体而言,成功实施取决于对干预措施的预期成果及其在实际中如何发挥作用保持共同愿景,持续与有影响力的政治和组织领导人接触,积极应对现有服务和专业人员的焦虑情绪,并与社区团体合作。