Integrated Care – Redesigning how we work in healthcare

April 3, 2023

Integrated Care – Redesigning how we work in healthcare

Dr Susan Kent, Associate Professor Dublin City University (DCU)

IFIC Senior Associate

IFIC is delighted to celebrate World Health Worker Week with people and organisations globally.

Earlier this month the WHO announced the end of the global Covid-19 pandemic[1]. Health workforces and organisations could be forgiven if they have missed this announcement, as they deal with the backlog of scheduled and missed care that has occurred during the pandemic period. Whilst researchers begin to anticipate, prepare and predict the next communicable pandemic, the global health workforce don’t stop for breath as they catch up on the deferred population needs over the past three years and the increasing non-communicable disease epidemic.

The pre-pandemic pressures of a health labour workforce shortage that were predicted and experienced, are now being felt worldwide. Health workforces have been extremely resilient and adapted to the population needs, however, in the post-pandemic health workplaces, coping with and tolerating the current demands are unsustainable in the current formats. We now have exacerbated problems of increased workforce stress, increased patient acuity with finite resources, all driven by a global demand to point toward a shift in healthcare into the self-management and community care setting.

Without shared governance, a work plan and sufficient resources, stress to provide integrated care that is quality assured and safe will further add to the burden experienced by the workforce. As a result our workforce are leaving healthcare for other careers and jobs that they feel they can fulfil with purpose and results. This has been lost in healthcare were stress is exacerbated because of the added burdens of trying to do more with less!

Integrated care is not about joining together an acute and community structure, workforce or organisation. It is ‘a fundamental design principle’ [2]about providing a continuum of care for a person regardless of the setting or care provider. It is about universal health coverage[3] with access and the provision of care by a health workforce that is enabled and supported to be agile and creative in healthcare delivery. Our workforce need to be supported to activate all their talents and be allowed to innovative care to meet the population needs from lowest to highest complexity. Integrated care workforces respect and value each other and work to impact patient care. Achieving this will take a leap of faith for employers and healthcare workers and will result in organisations attracting more staff.

The health workforce have been outstanding during the pandemic; pivoting, reskilling, educating, and all round stepping up to the needs of our global population. This has seen the workforce developing hybrid practices outside of normal practice. This is a critical skill and talent for delivering integrated care. Employers need to capture this ability and invest in the development and support of the workforce to achieve integrated healthcare. This includes investing in the workforces’ physical and psychological welfare. It also includes responding to the workforce voices who call out for investment in career development, flexibility in work schedules, change of geographical settings and (in 4^th place) compensation[4]. In short, a demonstration of value for those who care. To deliver healthcare policy, healthcare workers and organisations need to be funded by Governments to allow them to evolve and provide innovative and creative integrated care. This will go some part in demonstrating the value of our healthcare staff and lead to attracting staff to health workforces.

[1] https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing—17-march-2023

[2] https://integratedcarefoundation.org/about-ific/purpose

[3] https://www.who.int/health-topics/universal-health-coverage#tab=tab_1

[4] https://www.forbes.com/sites/debgordon/2022/05/17/amid-healthcares-great-resignation-burned-out-workers-are-pursuing-flexibility-and-passion/?sh=531ae5517fda