Health and social care delivery is a complex series of processes that are linked and interact together to achieve specified outcomes. Care coordination of these processes demands new pathways and services to improve the quality and efficiency of care and avoid unnecessary variation. The need for coordination increases when patient care requires the intervention of different professionals. Care pathways are widely used for a structured and detailed planning of the care process, including care standards. Standards’ setting, and use varies among process components. Professionals and organisations can adhere to the standards voluntarily, or they can comply with legal regulation.
Process coordination enables effective deployment and scaling up of integrated care by:
- Developing new processes and pathways that are replicable, funded and/or reimbursed, and agreed by pertinent stakeholders.
- Including an explicit statement of the goals and key elements of care.
- Defining evidence-based guidelines and agreeing on plans for formal introduction and scaling-up new services into practice.
- Negotiating with a broad range of experts and authorities the introduction and deployment of measurable care standards.
- Safeguarding the sustainability of new services and pathways.
No formal guidelines, description, agreements or standards on innovative coordinated care processes in integrated care services are in place or in development.
The stakeholders produce some guidelines and recognise the need for the standardisation of coordinated care processes, but there are no formal plans to develop it.
Some standardised coordinated care processes are underway; guidelines are used, some initiatives and pathways are formally described, but no systematic approach is planned.
Services, pathways and care processes are formally described in a standardised way by the stakeholders. A systematic approach to their standardisation is planned but not deployed.
Most coordinated care processes, including care pathways, are subject to a systematic approach, and are standardised and deployed throughout the whole region/country.
A systematic approach to standardisation of coordinated care processes is in place across the region/country. The processes are scaled up, maintained and redesigned according to standards.