European “Lifelong Learning” Programme, Leonardo Da Vinci, “Transfer of Innovation” Action

Summing up the main principles of integration

Karaberi Christina, EU Project Management (e-Trikala SA)

“PRISSM” 1ο Workshop, Trikala 04-05 February 2014

What is Integration

• By the term “integration” we define integrated care as well as designed and well organized series of services and care methods, focusing on the multi-dimensional needs/problems of one sole customer or of a group of people with similar needs/problems.

Main Objective:• Achieve optimal results• User satisfaction with the services provided• Cost reduction in terms of design, organization and

operation of such services

The need for integrated servicesIntegrated care can be conceived as client or consumer-driven care (Kodner 2003)In every field, like in industry, agriculture, commercial services or other public domains, including education, spatial planning in urban and rural areas, social care for the youth or public transport, management systems are replaced by integrated systems driven and developed because of the customers’ demand, but also for being efficient and cost effective, while at the same time offering greater satisfaction to employees and new career and professional development opportunities.An integrated service can:•support the customers’ “life universe”•combine the duties of professionals, unofficial care providers and volunteers•connect and combine services within organizations•coordinate services provided by various suppliers•be connected with the specific working framework or system.

Different integration levels

• Each level has internal sublevels• Structural integration is not

always optimal• No level is superior to others• The selection depends on the

service status, the objective and the institutional practices.

1st integration levelConnection/autonomy•This level works within the framework of current services.• In general, it accepts the current work allocation and abides by the suitability criteria for autonomous services.•Inclusion means sufficient referrals guiding the user to the right place at the right moment within the system•Suppliers understand who is responsible to pay each form of service. •There is no transfer of expenses and responsibilities.

2nd integration levelCoordination in networks•This level emerges in situations where regulatory bodies and service organizations are in search of a new balance in the service provision, the redefinition of main activities, clients’ flow and suitability criteria. This level is more structured but still greatly works through separate structures of current systems.•Its objective is to:1.Coordinate the benefits and the provision and use of services2.Disseminate information in a programmed way3.Manage transition from one situation to the other4.Allocate the main responsibility of coordination.

3rd integration levelFull integration•To orchestrate integrated care, a series of services should be connected, coordinated or incorporated. •Structural integration calls for the reconstitution of the entire personnel involved in different services and having different origin (working culture, know how/specialization, economic issues) within a single organization or decision making body (single structure), with a view to providing a range of services to a special population group.•One of the fundamental features of an integrated body is the creation of a single access area for potential users, so that the overall evaluation of their needs and the selection of the most appropriate services would be possible (evaluation of needs, case examination and provision by the service itself).

Obstacles to integration• Responsibility – In most systems no one is fully accountable either

with regard to integrated care and services provision or results at the professional, administrative and managerial level. This hinders decision making.

• Interaction problems – Frictions in the cooperation between organizations and professionals often reflect the fragmentation of the various systems involved. Frictions between professionals may impede cooperation and are due to differences in professional mindset and way of thinking.

• Systems driven by offer – Apart from the philosophy behind consumer or client-driven policies and systems, daily practice is still primarily defined by current offer and suppliers’ interests.

Obstacles to integration

• Human resources – Lack of personnel, inadequate quality of personnel and, on the contrary, overqualified personnel could hinder the integrated service implementation.

• Unrelated mentality.• Quality Management – Social services lack

quality systems and policies. In some cases, definitions of quality differ, as a result of which agreement is not achieved.

Designing integrationPhase 1: Careful study – “Is integration an option to us?”

Phase 2: Investigation – “How should we start?” Phase 3: Practical issues – “How should we design an integrated service?”

Phase 4: Implementation – “How could we make an integrated service work?”•How should we design a project’s organization to prepare its implementation?•How should we select the head of the project and which are the conditions to meet optimal operation?•How should we manage the cooperation procedure?•How should we monitor the progress of preparations?•What are the helpful elements and the obstacles towards implementation?•How could we identify resistance and deal with it? Phase 5: Evaluation – “How could we decide whether to keep on?”

Implement what we have learned