Readiness to Change to enable more Integrated Care

Objectives:

If the existing systems of care need to be re-designed to provide a more integrated set of services, this will require change across many levels, the creation of new roles, processes and working practices, and new systems to support information sharing and collaboration across care teams. This will be disruptive and may be viewed negatively by workers, press and public, so a clear case needs to be made for those changes, including a justification, a strategic plan, and a vision of better care.

  • Creating a compelling vision, with a real sense of urgency, and enlisting stakeholder support including political leadership, management, care professionals, public and press.
  • Accepting the reality that care systems are unsustainable and need to change.
  • Publishing a clear description of the issues, the choices that need to be made, and the desired future state of the care systems, stating what will be the future experience of care.
  • Creating a sense of urgency to ensure sustained focus, and building a ‘guiding coalition’ for change.

Indicators of maturity:

Evidence of public consultation; a published plan with clear strategic goals & milestones; a plan embedded in national/regional health policy; evidence of effective stakeholder engagement; emergence of leaders and champions of change; broad political and public support.

Assessment:

  1. No acknowledgement of crisis
  2. Crisis recognised, but no clear vision or strategic plan
  3. Dialogue and consensus-building underway; plan being developed
  4. Vision or plan embedded in policy; leaders and champions emerging
  5. Leadership, vision and plan clear to the general public; pressure for change
  6. Political consensus; public support; visible stakeholder engagement.
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