integratedcarefoundation.org€¦ · Web viewSue Ward, Respiratory Clinical Nurse Specialist and Trish Freer, Health Programmes Manager PHO, ... World Health Organization (WHO)

COLOUR CODE

Theme 1. Promoting the health of children and families Theme 2. Engaging and empowering people and communities Theme 3. Re-orienting the model of care Theme 4. Taking measures to improve quality Theme 5. Funding and incentives that promote health outcomes Cross-cutting Theme: Education & Training in association with the Integrated Care Academy© Cross-cutting Theme: Implementation International Journal of Integrated Care

* Denotes that paper or poster has been selected for Best Paper/Best Poster Award ** Nominated by two reviewers

Draft Programme – subject to change 1

Wednesday, 23 November 2016

07:30 Registration, refreshments, exhibition, posters and networking

9.00 – 10.30 PARALLEL SESSION 1 1. Workshop: Developing policies to support integration of mental health services

2. Workshop: Value-based approaches to Integrated Care

3. Workshop: Improving transitional management, introducing the Special Interest Group Intermediate Care

4. Workshop: iCoach 5. Workshop: Cross-cutting Implementation (AQuA)

Chaired by Prof David Perkins, University of Newcastle, Australia

So much planning in Australian mental health, so little change: towards an implementation toolkit (200)(Roberts, Russell James et al)

A Whole of System MH&A Integration Transformation Agenda in Counties Manukau District Health Board (226)(Brown, Wendy et al)

Mental Health Integration Past, Present and Future: National Survey into Mental Health Integration in England (212)(Lilo, Emad)

Chaired by Valentijn, Pim Peter

Value-based integrated care: Exploring strategies to enhance the uptake of integrated care (145)

Chaired by Anne Hendry

Identifying communities at high risk of re-admission in Singapore and understanding their needs during transition of care from hospital to home (157)(Chan, Darren Yak Leong et al)

Assessment tool for early prediction of patients in an acute hospital requiring long term institutional placement (151)(Chew, Melissa)

Towards Integration: Dispatches from the Front Line (218)(Pert, Harry et al)

Can we predict who we will see in hospital next year? (192)(Navin-Cristina, Tina)

Chaired by Barson, Stuart

An Outcomes Framework for Community Pharmacy Services (50)

Chaired by McNaney, Nicki

Using a system change model to develop system leadership teams (162)



6. Crosscutting Education - Integrated Care Academy ©Part 1Chaired by Viktoria Stein, Robin Miller and Jacquie Cummings

What is Integrated Care?- Overview of key concepts

and models- Update on latest evidence- Measuring integrated care- Supporting inter-

governmental and inter-sectoral collaboration

10.30 – 11.00 Refreshments, exhibition, posters and networking

11.00 – 12.30 PARALLEL SESSIONS 21. Workshop: Case studies highlighting integrated mental health services

2. Workshop: Whanau Ora and Te Tiriti

3. Predicting hospital (re)admissions – improving transitional care

4. Redefining the role of pharmacists: the New Zealand experience

5. Workshop: Implementation - Policy design and implementation (based on WB Poland Workshop)

Chaired by Prof David Perkins, University of Newcastle, Australia

Clinical Video Telehealth for Mental Health Care: Operations, Engagement and Outcomes (160)(Naseem, Ahsan)

The decentralization and integration of Norwegian

Chaired by Keelan, Tricia, Compass Health

Searching for Te Tiriti in Primary Care (203)

Implementing Stratification by Predictive Risk in General Practice (180)(Hannah, Damien John)

Stratification of patients by risk of acute hospitalisation – algorithm development, initial implementation and future strategy (163)

Supporting Medicines Adherence (165)(Hannon, Robbie)

Better than an iPad app, a Clinical Pharmacist in your practice (168)(Duck, Brendan James et al)

A Service Evaluation of the

Chaired by Chai Chuah and Anne Hendry

Population base integrated care in Poland- policy process (221)(Koziel, Anna et al)

The Five Eyes of Innovation (198)(Yap, Jason)

Critical Success Factors for Regional Health Systems - An


psychiatric services and possible implications for coercive practices (115 + 149)(Wynn, Rolf and Myklebust, Lars Henrik)

CDHB/ Police Watch-house Nurse Initiative (95)(Howie, Stephen James)

Implementing new models of integrated mental health care: what impacts effective performance? (126 + 130)(Ehrlich, Carolyn)

(Grant, John Robert)

Identifying and Selecting Patients for Integrated Care Interventions in NSW: Unpacking Risk Stratification (137)(Lilley, Erin K)

A Real-time Frequent Hospital Admitter Risk Stratification Model (FAM-FACE-SG score) to predict “Familiar Faces in Singapore” (11)Dr. Low Lian Leng, Singapore Health Services

Integrated Care for Emergency Medical Patients - Irish Acute Medicine Programme (93)Dr Orlaith O Reilly, National Clinical Advisor and Programme Lead, Health & Wellbeing, Health Service Executive – South (SE), Ireland

impact of a Pharmacist Prescriber managing patients with diabetes in primary care (38)(Muller, Kerry Anne)

42 Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience (Officer, Tara Nikki et al) *

178 Reshaping the Existing Landscape: a collaborative approach to managing diabetes in General Practice (Bhawan, Sandy et al)

International and Local Comparison of What Makes Regional Health Systems Tick (207)(Yap, Jason)

Evolving Integrated Care: Moving Towards a Population Health Approach (129)(Baker, G. Ross et al)


6. Crosscutting Education -Integrated Care Academy ©Part 2Chaired by Viktoria Stein, Robin Miller and Jacquie Cummings

Status Quo of Integration Process:- Introduction to Framework for Evaluation of Integrated Care Experience- Small group work- Plenary discussion

12.30 – 14.00 Buffet Lunch, exhibition, posters and networking

13.00 – 14.00 Lunchtime Workshops

1. Oral Poster Session: Engaging children, families and communities

2. Workshop: Curricula Development for Integrated Care

3. Workshop: Quality Expeditions for GP Federations (13)

4. IJIC: Meet the Editors

Perceptions about Perinatal Deaths in the Mountainous Villages of Nepal: Fatalism and Acceptance Contributing to Poor Perinatal Survival (171)(Paudel, Mohan)

An integrated model of care for children at risk of developing

Chaired by Christopher Kewley

Confronting the paradigm of discipline specific expert knowledge: Is professional integration the Holy Grail for sustainable and authentic models of co-production and integrated care? (125)(Kewley, Christopher)

Chaired by Wilson, Andrew


chronic respiratory disease (64)(Aish, Harley et al)

Where Youth Justice and Health Intersect (56)(Sharp, Robyn)

Inter Professional Paediatric Bronchiectasis Clinic (139)(Laker, Nikki Ann)

I am a single mother of seven running a household! Professionals mastering identity ambiguity to improve participation in a small-scale nursing home (161)(Koster, Luz Angela)

engAGE – Local Integrated Multidisciplinary Teams for Older People (197)Lucy Fergus, Hawkes’s Bay DHB

Using action research for workforce development and planning in integrated care (150)(Akehurst, Beverley JOY)

14.00 – 16:00 PARALLEL SESSIONS 31. Healthy children: whanau ora around the world

2. Co-designing care – empowering people

3. Improving patient journeys through integrated care pathways

4. Creating networks to provide holistic care for vulnerable populations

5. Implementation: Using data to improve service design

Ha ngawiri (Breathe Easy) (141)(Inker, Katie)

Mana Tu Diabetes (201)(Jansen, Rawiri)

Respiratory Patients Breathing Life into the Canterbury Integrated Respiratory Service (22)Louise Weatherall, Community

Integrated management pathways for alcohol and drug clients into treatment (impact) service reduces emergency department visits (155)

The Inner Sydney Urban Partnership for Health and Wellbeing (146 + 190)(McGeorge, Peter et al)

National Child Health Information Programme (81)(Gale, Richard, Orion Health, NZ) **


Improving Integrated Management of Newborn and Childhood Illnesses in Northern Uganda (58)(Chitashvili, Tamar) **

Kids GPS Integrated Care - Leaving the Ivory Tower (49)(Altman, Lisa)

Paediatric Optometry Alignment Project (69) (Newcomb, Dana)

Respiratory Nurse, Canterbury Clinical Network

Using co-design process to develop care options for people with chronic and complex care needs across four community health services in the (223) (Sinnott, Margaret) *

Empowering Community-Driven Change: Leadership in Southcentral Foundation’s Nuka System of Care (158)(Gottlieb, Katherine)

Developing an improvement leaders fellowship programme and the evaluation of the integration of patient fellows (114)(Myron, Rowan Rachel et al.)

The Unmet Needs of Patients and Carers within Community Based Primary Health Care (213)(Kuluski, Kerry et al)

Connecting communities: realizing the values of local networks in service integration (46)David Philip Morris, UCLAN

(Demirkol, Apo et al)

A randomized controlled trial measuring the effectiveness of a biopsychosocial integrated care model, care pathway and enhanced patient navigation for the management of patients with Chronic Obstruction Pulmonary Disease (COPD) in the community (217)(Kannusamy, Premarani)

Better Journeys for People with Dementia in Northern Sydney (179)(Olivetti, Lyn et al.) *

Integrating care planning for cancer patients: A scoping review (193)(Khan, Anum Irfan; et al)

Standardising care for heart attack (STEMI) patients, Ireland (199)Dr. Siobhan Jennings, Consultant Public Health Medicine, Department of Public Health, Dr. Steevens's Hospital,

Equally Well: together we are making a difference (85)(Lockett, Helen) *

Re-orienting models of care: the creation of integrated physical and mental services (143)James Baker, Simon Besley and Allison White, North Sydney Local Health District Mental Health & Drug and Alcohol *

Assessment and Management of Self Harm in Emergency Departments in Ireland: The National Clinical Programme (204)(Wrigley, Margo)

Relationships count – person centered wellbeing support in general practice (80)(Copas, Susan Heather)

Precision Driven Health: A New Zealand Research Partnership (54)(Dobbie, Gillian)

Integration through Practitioner Ownership: A Welsh Story (202)(Behl, Raman) *

The development story of creating a whole of system cloud-based platform for supporting quality improvement for integrated care (187)(Carswell, Peter)

Using Front Line Networks to Develop and Implement Data Driven Policy (67)Richard Lewanczuk, Alberta Health Services, Canada

Preliminary report of unmet needs in persons living with physical deficiencies in Quebec, Canada: a target for service integration (154)(Raiche, Michel et al)

6. Creating the evidence to


inform research and policy

Integrated categories for integrated care - the importance of patient centred categories (24)(Hoyle, Philip)

Integrated Care: Better and Cheaper (7)Prof Guus Schrijvers, Chair, International Foundation for Integrated Care (IFIC)

Inter jurisdictional governance for a health system – is it possible? (111)(Nicholson, Caroline et al)

Integrating Our Knowledge of Integrated Care – A Framework for Knowing, Understanding, Improving and Sharing What We Know (208)(Yap, Jason CH)

62 A Systematic Review of Indicators to Measure Population HealthProfessor Julian Thumboo, Director, Health Services Research & Evaluation, SingHealth Regional Health System, Singapore Health Services


16:00 – 16.30 Refreshments, exhibition, posters and networking

16.30 – 18.00 PLENARY 1 – Taking measures to improve quality

Chaired by Dr Janice Wilson, Chief Executive, Health Quality & Safety Commission (HQSC)

Using frameworks to measure and promote quality and integrated care: lessons from USA Dr Richard Antonelli, Medical Director of Integrated Care, Medical Director of Physician Relations and Outreach, Boston Children’s Hospital/ Harvard Medical School

Getting the measure of integration: lessons from New Zealand (185)Richard Hamblin, Director, Measurement and Evaluation, Health Quality & Safety Commission

Real-life data analysis and evaluation at the Clalit Research Institute: Data-driven policy in action for improving qualityDr Maya Leventer-Roberts, Director Translational Policy, Clait Research

Questions and discussion

18.00 Welcome Drinks

19.30 (TBC) Stakeholder Dinner (Invitation only)


Thursday, 24 November 2016

Main Theatre8.30 – 9.15 Powhiri

9.15 – 9.30 Official OpeningHon Dr Jonathan Coleman, Minister of Health and Minister for Sport and Recreation, Ministry of Health

9.30 – 11.00 PLENARY 2 – Promoting the health of children and families/whanau

Chaired byProfessor Alan Merry, Chair, Health Quality & Safety Commission (HQSC)

Developing integrated care models for children and their familiesFionnagh Dougan, Health Service Chief Executive and Frank Tracey Executive Director, Community, Mental Health and Statewide Services, Children’s Health Queensland

Caring for Country Kids: Improving the Health and Wellbeing of Children in Rural and Remote AreasLindsay Cane, CEO, Royal Far West ‘Caring for Country Kids’, Sydney, New South Wales, Australia

Next Generation StudyDr Judith Sligo/Assoc Prof Bob Hancox, Otago University

11.00 – 11.30 Refreshments


11.30 – 13.00 PARALLEL SESSIONS 4

1. Promoting a healthy life through education and activation

2. Technology-supported care 3. Towards health care homes (medical homes) in local neighbourhoods

4. Integrated care measurement frameworks

5. Implementation: QI frameworks to support change

224 No single intervention will solve the obesity epidemic – RACP physicians and paediatricians exploring points in the life cycle to prevent and manage obesity for children and families (Bullen, Chris)

177 Health 4 Life. Improving Maternal Physical Activity and Nutrition Tanya Radford, Health Promotion Team Leader, Te Awakairangi Health Network and Tricia Keelan, General Manager | Māori and Population Health, Compass Health

134 Supporting Weight Management in Primary Care - ABO Programme – Brief Opportunistic Intervention & Ongoing Management (Jones, Philippa Mary)

Call To Action Through Sport (Sweeney, Dave) (91+92)*

106 Promoting Patient Empowerment and Engagement in Care: The U.S. Veterans Health Administration (VHA) Home Telehealth Program(Walker, Mary) *

215 Chronic Heart Failure Care Model for Home Monitoring of Patients Dr Rajiv Jayasena, Business Relationship Manager & Victorian Lead, eHealth Research Program, CSIRO Health & Biosecurity Business Unit and Iain Edwards, Director of Integrated Care & Dental, Peninsula Health

2 Patient centred care - Green Cross Health's approach to managed disruption (Simon, Jonathan Edward)

174 Owning My Gout – Engaging people with Gout in a Pharmacist-Led Collaborative Gout Management Service (Rolland, Ta-Mera Cherina)

5 Preliminary Experiences with the Integration of a Patient-centered Medical Home into Ambulatory Healthcare Services Centers in Abu Dhabi (Baynouna Al Ketbi, Latifa Mohammad et al)

100 Weaving many strands: Northland Neighbourhood Healthcare Home Development Liane Penney and Jenni Moore, Northland DHB

72 Integrated Healthcare Homes & Neighbourhoods: governance, clinical, managerial & evaluation matters (Liaw, Siaw-Teng et al) **

182 Health Care Home - what is it? (Parker, Helen)

26 The Western Sydney Integrated Care Program (WSICP): Qualitative Evaluation (Trankle, Steven A et al)

144 Validating the Rainbow Model of Integrated Care Measurement Tool: results from three pilot studies in The Netherlands, Singapore and Australia(Valentijn, Pim Peter et al)

90 Whole of system measurement for integrated care: The Counties Manukau experience and creation of aspirational goals (Gauld, Robin et al)

183 We know what to do, but how do we do it? A metanarrative review of implementation frameworks to guide the iCOACH project (McKillop, Ann et al)

123 Organizational Context and Capabilities for Integrating Care: A Framework for Improvement (combined with 153)(Evans, Jenna M et al)

107 South Island Well Child Tamariki Ora Quality Improvement Project Anna Foaese, South Island Well Child and Tamariki Ora, Quality Improvement Project Manager, South Island Alliance Programme Office and Michael McIlhone, Director of Nursing, Pegasus Health

142 Sharing Coordination of Health Services on Flinders Island using an applied continuous quality improvement approach (Ahmed, Sarah S et al.) *

117 One Client, One Team - Health Care Integration for Complex Populations: Advancing Integrated Care for Palliative Patients (Goldhar, Jodeme)

169 Planned Proactive Care - a Quality improvement framework (Hall, Lucy et al)


6. Implementation: Engaging the workforce to lead change

176 Integration between general practitioners and other health care providers in New Zealand in 2015(Townsend, Frances et al)

14 An investigation into the barriers and facilitators of acceptance, and use of Bay Navigator Pathways by general practitioners in the Western Bay of Plenty Dr. Anel Reyneke, Department of General Practice and Rural Health, University of Otago and GP in Papamoa, New Zealand

39 Engaging Clinicians to lead improvement of care integration (White, Sharyn Ann)

128 Implementing peer support workers in clinically oriented sub-acute mental healthcare teams: New approaches - new challenges (Ehrlich, Carolyn et al)

77 Designing a sustainable and flexible GP contribution to multidisciplinary integrated care


(Bishop, Susan et al)

13.00 – 14.30 Buffet lunch, exhibition, posters, networking and lunchtime workshops


1. Workshop: Whanau Tahi 2. Oral Poster Session: Using technologies to improve services

3. Workshop: Implementation – the experience with medical homes in Australia and North America

66 Electronic alert on diagnosing an HIV indicator condition in Primary Care (Cayuelas, Laia et al)

136 The usability, usefulness and use of a national collaborative IT platform for the purpose of continuity of careChelsea Ah, Senior Manager, Clinical Transformation Services Information Services Division, MOH Holdings Pte Ltd

159 Using Information Communication Technology in Models of Integrated Community-Based Primary Health Care: Exploring ICT in the iCOACH Study(Steele Gray, Carolyn et al)

Chaired by Rahbar, Safa Majidi et al

205 Discussion on the Implementation of the Patient Centred Medical Home model - Experiences from Australia

97 Reform but no change: The case of aging at home policy in Ontario, Canada (Peckham, Allie et al)

+ Prof Claire Jackson and Dr Richard Antonelli


71 eHealth and Integrated Primary Health Care Centres (Liaw, Siaw-Teng et al)

59 Seeking to Understand the Patient Experience & Co-Design a Self-Management App (Charles, Jocelyn Elizabeth)

32 Democratizing Virtual Reality Treatments in Mental Care (Gelabert, Joan MIquel)

3 Tweets are not always supportive of patients with mental disorders (Wynn, Rolf et al.) *

21 Retrospective Analysis of Telemonitoring (RATE)(Kohler, Friedbert; et al)

18 Admission 2 discharge together (A2D) - improving the hospital journey for people with an intellectual disability (O'Connor, Lif et al.)

184 Practice Population Profiling – Using PMS data for patient and practice benefit (Abernethy, Paul et al)


Main Theatre

14.30 – 16.00 PLENARY 3 – Reorienting the model of care

ChairDr Jeff Lowe, Chair, General Practice New Zealand (GPNZ)

Integrated Care in Action: The Counties Manukau Experience (105)Benedict Hefford, Director of Primary Health and Community Services, Counties Manukau Health

Moving towards Integrated Care Organisations (ICOs): Lessons from the Basque Representative from O+berri / Basque Foundation for Health Innovation

A vision for general practice and a sustainable health care system: lessons from Australia Dr Steve Hambleton, Chair, Queensland Clinical Senate


16.00 – 16.30 Refreshments, exhibition, posters and networking

16.30 – 18.15 PARALLEL SESSION 5

1. Improving access to services and information for hard to reach populations

2. Empowerment through self-management

3. Key enablers for multi-disciplinary and inter-sectoral collaboration in primary care

4. Measuring integrated care to improve quality

5. Better value for money

30 Dilly Wanderer initiatives – Wollondilly Health Alliance (Lawrence, David et al.) *

20 A community cultural literacy programme becomes

51 Introduction of the DESMOND Programme for Type Two Diabetes to WellSouth Primary Health Network Rebecca Grant, Long Term Conditions Community Nurse,

210 Co-location of multi-disciplinary professionals within Primary Care Centres in Italy: how do they collaborate? An insight on three cases studies from Tuscany Region through

36 GPVu: Your Practice Insight (Allen, Gary, Pegasus)

127 Integrated care for participants attending general practice: a record linkage study

195 HealthLinks: Incentivising better value chronic care in Victoria (Ferrier, Denise et al.)

8 Fifty shades of fair? A pilot to explore values in the health


the trojan horse. (Te Karu, Leanne)

110 A model connecting practice, research and policy to improve refugee health outcomes (Combined with 109)Caroline Nicholson, Director, Mater UQ Centre for Integrated Care & Innovation

98 Caring for Caregivers: Establishing Resilience through Social Capital Allie Peckham, Postdoctoral Fellow, University of Toronto, Institute of Health Policy, Management and Evaluation*

118 Transfer of the idea of the Managed Clinical Network into less advanced settings (Asoka, Tarry)

WellSouth

164 Manawanui whai ora kaitiaki: empowering self-management through a partnership approach (Webber, Lindsey Ann)

27 Transforming patient engagement to take charge of their health and wellbeing (Dowdle, Diana)

186 Creating self-management teamlets in a primary care clinic; the successes of a clinical-peer team (Didsbury, Leona Pearl et al) *

113 Are patient and carer experiences mirrored in the Practice Reviews of Self-Management Support (PRISMS) provider taxonomy? (Sheridan, Nicolette et al.)

Social Network Analysis(Bonciani, Manila)

68 "To be followed up in general practice" - developing and implementing a shared care model for prostate cancer. (Bro, Flemming et al)

83 How are co-located primary health care centres integrating care for people with chronic conditions?Julie McDonald, SEaRCHSouth Eastern Sydney Research Collaboration Hub, University of New South Wales

25 GPs- You Can Make Time in Your Day - You can regain Control (Edwards, Jan et al) *

based on the 45 and Up population cohort study Julie McDonald, SEaRCHSouth Eastern Sydney Research Collaboration Hub, University of New South Wales

75 Patient Reported Measures: Delivering Outcomes and Experiences that matter to patients in NSW (Tinsley, Melissa)

188 Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey: Provisional results (Derrett, Sarah et al.) *

28 A marketing approach to innovation in chronic care: new value for patients in lombardia region (Buccoliero, Luca et al)

resource allocation process (Hurford, Grace)

135 The value based Logan Wellbeing Program successfully diverts inpatient funding, improving patient and economic outcomes (Crompton, David et al.) *

222 Outcomes Based Commissioning - can the care really follow the patient? An Australian perspective (Sheather-Reid, Rachel) *

6. Education & Training: Changing attitudes: enabling health workforce to provide holistic care

1 Relationship Centred Practise (Phillips, Andrew John)

133 How do health


professionals work in a recovery-oriented way? (Ehrlich, Carolyn) Combined with: 132 Uncovering the work involved with personally supportive recovery-oriented practice (Chester, Polly et al.)

12 The Pegasus Health Small Group Education Programme (Burke, Marie)

166 K'aute Pasifika Workplace Health and Well-being Programme. Le’aupepe Elisapeta Karalus – Chief Executive Officer, K’aute Pasifika TrustKim Holt – General Manager, K’aute Pasifika Trust.

189 Integration of Respiratory Services in Hawke's BaySue Ward, Respiratory Clinical Nurse Specialist and Trish Freer, Health Programmes Manager PHO, Health Hawke’s Bay – Te Oranga Hawke’s Bay

20.00 Congress Dinner



Friday, 25 November 2016

Main Theatre

8.30 – 10.30 PLENARY 4 – Engaging people and communities

Chaired byDr Viktoria Stein, Head of the Integrated Care Academy ©, International Foundation for Integrated Care (IFIC)

From cooperation to partnership and patient leadership: reflections from the English NHSJocelyn Cornwell, CEO, The Point of Care Foundation

WHO efforts in measuring people and community engagement in healthcareDr Hernan Montenegro, Coordinator, Services Organization and Clinical Interventions Unit, Service Delivery and Safety Department, World Health Organization (WHO)

xxxAwerangi Tamihere, Director Srategy and Design Thinking for Outcomes, Te Whānau O Waipareira


10.30 – 11.00 Refreshments

11.00 – 12.45 PARALLEL SESSIONS 6

1. Asking people what they want

2. Putting people first – changing regional health systems

3. Measuring what matters: incorporating values as outcome measures

4. Incentivising integration of services – innovative funding models

5. Implementation: Integrated care in AsiaPacific

This session will run to 1pm

194 Pacific peoples perspectives of Integrated Care services (Ryan, Debbie)

61 'Doing Better Together': Developing a cross-agency regional child health and wellbeing plan (Shaw, Miranda

Chaired by Awerangi Tamihere 33 An Evaluation of Payment Incentives for Community-Based Psychiatric Care in Ontario, Canada (Rudoler, David)

76 The challenge of making health services people-centred: how are policy-makers in Asia approaching it?


82 Self-determination: what do people who experience severe mental illness want from public mental health services? (Mattner, Sandra)

99 Frail older people’s use and experience of the Irish healthcare system: a mixed methods study to inform the design of integrated models of care (Roe, Lorna Dorothy et al)

220 Networks for care: Improving quality of hospital care for rural communities (Atmore, Dr Carol Margaret)

10 Dying well? What people with dementia need from carers at the end of life. (Hurford, Grace)

Jane)

55 Delivering an integrated system of care in Western New South Wales, Australia (McLachlan, Scott et al.)

116 One Client, One Team - Health Care Integration for Populations with Complex Care Needs: Developing an Integrated Program through the Lens of Clients and Families (Goldhar, Jodeme)

63 Mixing it up: private, public, federal, state, seeking health outcomes in an integrated primary care centre – the Oran Park Family Health experience! (Duggan, Justin et al)

29 An Integrated Health Collaboration – A Localized Solution (Pennock, Rene et al)

34 Paying for primary care: The relationship between payment for primary care physicians and selection of patients based on case-mix (Rudoler, David Michael et al.) (one presentation)

94 Irish Integrated Care Programme for Chronic Disease - Supporting General Practice Dr. Orlaith O Reilly, National Clinical Advisor and Programme Lead, Health & Wellbeing, Health Service Executive – South (SE) Public Health

211 Innovative funding models to incentivise integrated care (Prior, Emily)

104 Flexible funding for effective, individualised, integrated care. (Smith-Merry, Jennifer; Gillespie, Jame)

16 Local Resource Based Community Care Development as Asset for the Silver Economy of the Region (TSARTSARA, Stella I.)

(Tan, Clive)

121 Integrated care in China, challenges and opportunities (CAI, HAO et al)

167 Developing of social and community prescription model as the third system for sustainable community-based integrated health care system Toshiro KUMAKAWA, Senior Researcher, Department of Health and Welfare ServicesNational Institute of Public Health, Japan

152 Effects of provider incentives in integrated healthcare delivery system reform: a quasi-experiment on patients with chronic diseases in rural China (Tang, Wenxi et al.)

60 Implementing an Integrated Care Framework in Singapore: The Experience of the SingHealth Regional Health System Professor Julian Thumboo, Director, Health Services Research & Evaluation, SingHealth Regional Health System, Singapore Health Services


156 A Model of Care for a Regional Health System (Ng, Yeuk Fan)

6. Implementation: Changing organisations/management to change service provision

7. Workshop: Introducing the Special Interest Group on Managing Complexity

147 GOODBYE COMAND & CONTROL – HELLO CIRCLES! (Saberi, Vahid)

131 Effective Organizational Leadership in the Implementation of Integrated Care; Lessons from 9 cases in the iCoach Project (Baker, G. Ross et al) +120 Managerial strategies for integrated care: Health care provider engagement in the iCOACH project (Shaw, James et al.) (one presentation)

122 Can complexity dynamics be harnessed to improve integration of care? The implementation of the Health Links in Ontario, Canada (Grudniewicz, Agnes et al)

Chaired by Anne Hendry

209 Learning from iCOACH: implementing integrated care for older adults with complex health needs (Wodchis, Walter P et al)

78 What does one learn from the implementation of a mandated integrated network for older adults across three different settings in Quebec (Breton, Mylaine et al)

138 The Future of Chronic Conditions Management in NSW: Integrated Care for People with Chronic Condition (Lilley, Erin K)

196 Anticipatory Care Planning in Scotland (Cumming, Stuart)

19 Developing a culture of health through a prevention pathway in


a French Mediterranean region (Reuzeau, Jean-Claude et al)

12.45– 14.00 Buffet lunch, exhibition, posters, networking and lunchtime workshops


1. Workshop: IBM Watson Health - Welcome to the era of cognitive health (119)

2. Oral Poster Session: Workforce redesign- the future workforce

3. Oral Poster Session: Measuring integrated care outcomes – improving access

Chaired by Parks, Shawn et al57 Promoting the delivery of integrated care to citizens through the area managers (de Matos, Rosa Valente)

52 Building better systems on strong relationships: A co-design case study of a local initiative Beth McPherson, Clinical Nurse Specialist (Lead) Acute Care,Leanne Bell, Clinical Nurse Specialist (Lead) Acute CareDeborah Davies, Nurse Director Primary and Integration, Mid Central DHB

53 Non-medical prescribing in New Zealand: Is it achieving its aims? (Smith, Alesha)

101 Quality Enhancement

15 Cost effectiveness of integrated care in patients with acquired brain injury (Carroll, Áine M)

41 Evaluating integrated social care by utilizing regional resources in Japan (Otaga, Masaaki et al.)

170 Integrated Care Management in Atrial Fibrillation is associated with improved outcomes – a systematic review and meta-analysis (Hendriks, Jeroen Marie Louis et al)

65 Integrated psychological care in Inflammatory Bowel Disease outpatients: Early data from a new initiative


Program: A Delirium-caring Culture Nurturing Program in Acute Geriatric Setting- 2-years Review (Tang, Lap Nin)

87 Turning the patient promise into reality(Cullen, Jane)

6 Remodelling care for low back pain: tripartite partnership among general practitioners, physiotherapists and hospital specialist’s Dr Jasper W.K. TONGDeputy Group Director, Group Allied HealthSingapore Health Services

Taryn Lores, Psychologist / Health Psychology Registrar, IBD Service, Royal Adelaide Hospital, Adelaide SA Australia

175 Understanding the audience: Improving the impact of public performance reporting on quality of care. (Kelaher, Margaret et al)

148 ICD (Integrated Cardiac Device) Care through PACED (Patient-centred and Cardiac Nursing Engaged Device) Services in a Hospital in Hong Kong (Leung, Yuen Wa et al.)

14.00 – 15.30 PLENARY 5 – Funding and incentives that promote health outcomes

Chaired byDr Nick Goodwin, CEO, International Foundation for Integrated Care (IFIC)

Keynote address: xxxxxHon Bill English, Deputy Prime Minister, Minister of Finance and the Minister Responsible for Housing New Zealand Corporation

Funding and incentives to promote health outcomes considering you experience of alliance contracting in CanterburyCarolyn Gullery, General Manager - Planning & Funding, Canterbury DHB & West Coast DHB

XXXXXX Gabriel Makhlouf, Secretary and Chief Executive, The Treasury

A funding model of shared savings on a regional meso-level – possible for countries with sickness funds or state owned health systems:


The OptiMedis-model of Gesundes Kinzigtal in GermanyHelmut Hildebrandt, CEO, OptiMedis and Gesundes Kinzigtal


TBC CLOSING CEREMONY

Poster Display Only (no oral presentation time allowed)

1. 31 SNOMED Browser and Web Services: Enhancing Primary Care & Emergency Services in New Zealand (Rauf, Abdul)2. 84 Cardiovascular disease risk and management in people who experience serious mental illness (Lockett, Helen et al)3. 9 Integrating Clinical Advisory Pharmacists in the Health Care Home (BRYANT, Linda Julia et al)4. 70 Analyze and improve the patient flow in hospital environments, with improved layout different sectors: A case study of Shahid Beheshti hospital, Iran (Sadeghi

et al)5. 140 HIV – PEP(Post-Exposure Prophylaxis) ACCESS PROJECT Sid Kaladharan, Project Officer- HIV & Sexual Health, HIV FOUNDATION QUEENSLAND6. 44 Organ transplant in India (OTII): Progress and challenges through net working system (Barik, Mayadhar et al)7. 103 Countdown to Success: Taking measures to improve quality Penny Impey, Service Improvement Manager, Auckland District Health Board8. 23 What do patients' want? Time to innovate medicine information leaflets (Young, Amber)9. 45 Integration of cure and care motivated by the hospital budget (Szynkiewicz, Piotr Rafal et al.)10. 214 A comparison of the policy and institutional environment relevant to community-based primary health care in Ontario, Quebec and New Zealand

(Tenbensel, Timothy Gerard et al.)11. 96 Beyond scale and spread: Organizational leadership in community based primary health care (Peckham, Allie et al)12. 79 Client-service engagement in social service provision as co-creation of value (Nicholas, Graeme)13. 4 Health professionals’ reactions to patients’ social media posts about treatment (Wynn, Rolf et al.)14. 173 Enabling intra-DHB patient-specific care for patients with intestinal failure (Fraser-Irwin, Cate et al)15. 48 Antiepileptic drug exposure in pregnancy and pregnancy outcome from national drug usage data (Richards, Noni)16. 112 Geographic and Perceived Healthcare Access Equity among Patients with Acute Cardiovascular Event in China (Ma, Xiaoguang)17. 88 What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

(Zhang, Yan et al)18. 181 The New Zealand health care system: Digital disruption, innovation and the opportunity for new approaches to integrating care (Marmoush, Ahmed et al)


19. Spiritual Care Advance Directive (SCAD) ®: A guide for a spiritual counselor to provide therapeutic and creative interventions at End-of-Life care. (Kim, James)

For further information, contact: Fiona Lyne, Director of Communications, International Foundation for Integrated Care [email protected]


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integratedcarefoundation.org€¦ · Web viewSue Ward, Respiratory Clinical Nurse Specialist and Trish Freer, Health Programmes Manager PHO, ... World Health Organization (WHO)