SCIROCCO-POL: maturity of integrated care
Business, Management and Services Projets de recherche appliquée et développement Vaud
Care integration aims to organize, coordinate and optimize the patient's care pathway in a context where care providers (hospitals, nursing homes, etc.) are traditionally organized in silos. The aim is to provide patients with the right care, in the right structure, according to their needs and at the right time. This type of organization is widely promoted by international consensus: it aims to improve patient care while limiting the associated costs.
In the canton of Vaud, the health authorities have supported the creation of three integrated care providers (Réseau Santé Balcon du Jura, Pôle santé Vallée de Joux, Pôle Santé Pays d'Enhaut). However, their performance is questionable. In the absence of tangible evidence, including at international level, this question is a recurring one: studies that attempt to measure and compare the performance of integrated care with silo systems suffer from several major methodological biases that render the results unusable. The Swiss case is even more complex, insofar as the data needed to carry out these studies (on health and costs) are unavailable, since they are in the hands of private insurers.
A EU-funded research project has circumvented these problems by developing the SCIROCCO tool to evaluate not financial and care performance directly, but the quality of the organization of integrated care. The tool is based on a logic similar to that of ISO certification, which has proved its worth. It takes the form of a maturity matrix of a country or region's organization for developing integrated care.
On this basis, the three ICPs have joined forces with HEIG-VD's "Management et système de santé" research team and Unisanté's "Systèmes et services de santé" sector to launch the SCIROCCO-POL project. The 18-month project is financially supported by Innosuisse.
The aim of the project is to recast the original tool into a version adapted to the specific context of an integrated care provider, and then to carry out a diagnosis of the maturity of care integration for each ICP. Similar work will be carried out for the integration of care in the Canton of Vaud, with the creation of a SCIROCCO-Canton and a related maturity diagnosis. Based on the results obtained, a roadmap and action plans will be drawn up for each of the three ICPs.
The challenges inherent in this project are 1) to transpose the original tool into a management and steering tool designed for integrated care organizations on the one hand, and Cantons on the other, 2) to identify the singularities of each ICP and 3) to involve multiple local stakeholders in the assessment process, i.e. some 150 people. If the results prove conclusive, the SCIROCCO-POL and SCIROCCO-Canton tools could be made available to other cantons and integrated care organizations.