Healthcare TransformationHealthcare DENMARK, 28th october 2014
by Heidi Juul Madsen, Head of Health, City of Odense
Odense – the main city and primary growth driver of the region
1,2 million inhabitants in the Region of Southern Denmark
Odense is the third largest city in Denmark with a population of 191,400
Odense covers an area of 306 km² 33,000 student places 100,000 workplaces 485,000 in the island of Funen Main city and growth driver in the Region
of Southern Denmark, and on the island of Funen, in terms of:
Size Labour market Settlement Cultural life Education Healthcare and trade
The demographic challenge: An increasing number of retiring citizens, and a decline in young citizens entering the labour marked
Increasing service demand
Growing expectations for individual considerations
The economy is under increasing pressure
Especially for Odense:
Low ratio of people with higher education
Low employment ratio
The overall challenges
New reality – New welfare
New reality
New conditions require
adjustment
Economic conditions
Expectations and demand
from citizens, the state etc.
New welfare
New approach to the new conditions
• Cooperation • Prevention• Partnership
The vision of Odense: From a large Danish city to a Danish metropolitan city
The projects are, collectively and individually, means to achieving this goal
This will be done in a sustainable way, with people in focus
Growth Attraction Transformation
The Integrated Care Programme
The motivation behind this project
Our services is challenged by an increasing number of elderly, people with chronic diseases, or mental health issues
Structural challenges expressed by lack of consistency and poor quality
The economical incentives rewards silo thinking and sub optimizing
An inappropriate changeover between sectors is often due to lack of insight in the combined course of treatment of the patient
The Integrated Care Programme is contributing to a new welfare model
We need to find new ways of working together!
The vision is to create an effective and compulsorycollaboration across sectors
TO partnership
FROM contracting parties
The citicens
General treatment
GP
municipality
hospital
Specialisedtreatment
prevention
Management by cooperation
We must lead across sectors and share responsibility for every patient
The foundation of the programme Status as a deregulated municipality The North West London Integrated Care Pilot Health agreements and patients course programs Data acquisition among general practitioners
AND we build on top of it
Target group 1:
Citizens challenged by stress, anxiety, or depression
”We see a substantial increase in health care costs among citizens challenged by
stress, anxiety, or depression”
Target group 2: The elderly medical patient
”We know that among elderly patients, 1 in 5 is re-admitted within 30 days”
Integrated Care samarbejdsmodellenProactive treatment: Shared data and stratification => patients in risk are found => shared plan of action is made
Compulsory collaboration:Shared tasks, shared responsibility and co-development of cross-sector and interdisciplinary teams
The collaboration model in the Integrated Care program
The early experiences
Elaboration The pilot Testing
The partnership agreement is politically approved
A scientific research programme held by the University of Southern Denmark is initiated
Agreement with an external evaluator
55 general practitioners on board since 1st of September – SAD:31 ; EMP:24
9 TSTs (SAD: 5 ; EMP: 4). They will have 5 meetings per year and 1 conference. The two first
meetings are taking place in November
25-35 patients per general practitioners per target group per year
93 citizens have already got a treatment plan
A status of the programme
2012-2013 2014 2014-2015
Future perspectives Each and every participant are crucial for the development of new welfare solutions!
The collaborationmodel is already being experienced as very meaningful AND:
As a faster and more focused treatment
Increased involvement and a greater overall view and coherence for the citizens
Improved prevention through an early and integrated treatment
Increased dialog, collaboration, and a common professional boost
More health for less money….? That’s the question!
For more information…www.integratedcare.dk
Partnerskabsprojekt med ligeværdige aktører. Der skal skabes et samarbejde mellem virksomheder med hver sit legitime (og konkurrerende) perspektiv.
Det er visionen, der er driveren. Borgerens perspektiv kan bidrage til at sætte egeninteressen på stand by. Faglig mening er afgørende.
Teoretisk fundament = relationel koordinering (Gittels).
Etablering af projektsekretariat med ”tre ben”
- processer skal styres og planlægges og uforudsigelighed rummes
- ejerskab hos alle interessenter skal mobiliseres
- indgå i dialog og forhandling – og være konfliktløser
- lede overgange mellem projektfaser og projektaktører
Erfaringer med det tværsektorielle samarbejde
Forskellige paradigmer mødes og brydes
Misforståelser og myter ”om hinanden”
Stærk fag-faglighed og mindre blik for ”overgangene”
Egeninteresser kan skygge for samarbejdet
Økonomiske incitamenter
Forskellige IT-systemer
Prioritering af tid (projekter tager tid fra kerneopgaven)
Særlige udfordringer
Topledelsen er rollemodeller, der går forrest
Tydelige mål og forventninger for samarbejdet
Få alle relevante parter med fra start
Procesledelse af samarbejdet
Skab enighed om den fælles opgave, men anerkend at uenighed er en kilde til nyudvikling
Fremdrag de eksempler, der går lidt skævt på grund af siloerne => bruges til læring
Kompetenceudvikling og lederudvikling sker tværfagligt og tværsektorielt
Værn om ildsjælene
Det gode tværfaglige samarbejde
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