Optimizing integrated care through a quality manager function fostering inter-professional collaboration, task shifting and digital integration: Optimal health care for the chronically ill in the Jura region
Project Abstract
Background: Switzerland’s healthcare system faces various pressures linked to an ageing population, the prevalence of chronic diseases, and workforce shortages. Responding to these challenges, the Réseau de l’Arc (RdA) was launched in 2024 as one of the country’s first integrated-care organisation. A specific insurance model, VIVA, is offered so to promote coordinated, patient-centred, and cost-efficient care. RdA warrants to encourage the prevention and continuity of care, for VIVA-ensurees. Central to this transformation is the introduction of care coordinators, nurses embedded within interdisciplinary teams to support chronic and complex patients. However, while these coordinators have proven valuable, quality management within specific VIVA-RdA processes holds potential for being strengthened. The project aims to strengthen VIVA-RdA’s integrated-care model through a new quality management framework. Its ambitions are to: (i) Improve patients pathways through collaboration and communication among multidisciplinary teams, and (ii) Establish systematic quality assurance via a KPI dashboard and shared digital tools, namely an electronic health agenda.
The implementation research by Swiss TPH in collaboration with the Basel Centre for health economics of the University of Basel, consists in analysing the process and outcome of the new quality manager function and quality assurance tools (KPIs and electronic agendas) on inter-professional collaboration, task shifting and digital integration. The specific objectives are:
- Investigate enablers and disablers of the quality management function and the quality assurance tools (dashboard and electronic agendas) on inter-professional collaboration, task shifting and digital integration
-
To analyse the views and acceptance of different health professional groups (general practitioners, hospital doctors, care coordinators, nurses, homecare staff) of the quality manager function and quality assurance tools
-
Assess effects of the personalized care plan on patient pathways and on patient outcomes of chronically ill
Of interest to the implementation research are aspects such as effects of the interventions on (i) the efficiency of service delivery by optimizing staff time, appointments, and resource utilization, (ii) coordination across different levels of care via shared electronic agendas, and or (iii) quality culture at the RdA. A mixed-method approach is being used. For investigating enablers and disablers of the quality management function within RdA (objective 1), it is proposed to use qualitative interviews with health providers (physicians, nurses/ care coordinators, social workers) as well as with chronically ill patients thereby the the interest is on effects of inter-professional collaboration, task shifting and digital integration on treatment pathways. The quantitative study may utilize a repated crosssectional design to assess the acceptance and view by health professionals (objective 2). Data may be collected at two time points: baseline (early stage of interventions) and 12 months post-intervention. Through the analysis of insurance claims effects of the interventions on patient pathways and on patient outcomes of chronically ill may be investigated (objective 3).
