Table 4

Elements of the integrated governance models identified in published papers (nā€‰=ā€‰21)
Element Interventions shown to be effective n = *[references]
1. Joint planning Joint strategic needs assessment agreed; formalising relationships between stakeholders; joint boards; promotion of a community focus and organisational autonomy; guide for collective decision making; multi-level partnerships; focus on continuum of care with input from providers and users. 18
2. Integrated information communication technology Systems designed to support shared clinical exchange i.e. Shared Electronic Health Record; a tool for systems integration linking clinical processes, outcomes and financial measures. 17
3. Change management Managed locally; committed resources; strategies to manage change and align organisational cultural values; executive and clinical leadership; vision; commitment at meso and micro levels. 17
4. Shared clinical priorities Agreed target areas for redesign; role of multi-disciplinary clinical networks/clinical panels; pathways across the continuum. 16
5. Incentives Incentives are provided to strengthen care co-ordination e.g. pooling multiple funding streams and incentive structures, such as equitable funding distribution; incentives for innovative and development of alternative models. 15
6. Population focus Geographical population health focus. 13
7. Measurement ā€“ using data as quality improvement tool Shared population clinical data to use for planning, measurement of utilisation focusing on quality improvement and redesign; collaborative approach to measuring performance provides transparency across organisational boundaries. 12
8. Continuing professional development supporting the value of joint working Inter-professional and inter-organisational learning opportunities provide training to support new way and align cultures; clearly identifying roles and responsibilities and guidelines across the continuum. 11
9. Patient/community engagement Involve patient and community participation by use of patient narratives of experience and wider community engagement. 8
10. Innovation Resources are available and innovative models of care are supported. 7

*Number of studies reporting the specified element.

Nicholson et al.

Nicholson et al. BMC Health Services Research 2013 13:528   doi:10.1186/1472-6963-13-528

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