It is important to gain insight into values, because they can help explain behaviour in cooperation. Additionally, they can form a reference point for the development and improvement of integrated care. We identified 23 values in our systematic literature review.
The findings of the systematic review are published in the ‘International Journal of Integrated Care’ on 15 November 2018. As a next step the values will be refined by a panel of 33 experts from 13 countries. The results will then be applied in practice.
More complex care needs
Integrated care is becoming increasingly important because people are getting older and the number of people with chronic diseases is rising. As a result, more people have more complex care questions that affect different life domains. Therefore, knowledge and expertise is required that transcends various disciplines and sectors, such as long-term care, social care, primary care and housing. Integration of services ensures better alignment, so that people can be offered person-centred care. Care should be organised around a person, since people do not think and live in separate disciplines and domains.
The role of values in behaviour and cooperation
Already much knowledge about the functional aspects of integrated care has been developed, such as case management, the composition of multidisciplinary teams and shared information systems. However, it is also important to address the normative aspects, such as the underlying values of integrated care. Insight into these can teach us why collaboration does or does not work and may help to make improvements, given that values largely explain behaviour and decision-making. Consider, for example, street camera surveillance. Some people find privacy especially important and therefore will be against it. But those that find safety more important will be in favour.
The value of values
The set of 23 values can form a common reference point for the development and improvement of integrated care. The values can also help to explain and interpret behaviour in integrated care. For example, do the actors involved have the same values or different ones? Finally, the values could form a framework for governance and management in integrated care. For instance, participants in a partnership could agree that three values should serve as the most important starting point for their conversation or as an orientation point for evaluation.
In integrated care a strong formal hierarchy is often absent, while cooperation based on mutual dependencies is more common. This implies that it is more useful to focus on values in governance than on procedures and rules of conduct. Suppose you want to divide sixteen marbles among four people. If we record and agree with one another that they should be distributed equally, everyone would get exactly four marbles. You could also let professionals decide what equality means at that moment and what the most suitable option for that specific situation would be. This presumably would create more ownership and flexibility. If you start from values, you have room to respond to specific needs of care users and professionals.
Quality care for service users
Hopefully, these values will ensure that we can better organise cooperation in integrated care. This means, for example, that service users (clients) will not have to tell their story three times. Or that they no longer have to worry about whether the coordination between professionals is going well. It is therefore very important to also examine the values of the service user in the further course of this research.
This PhD research is conducted under the supervision of prof. dr. Mirella Minkman, Associate Professor of Innovation of Organisation and Governance of Integrated Long erm Care at the TIAS School for Business and Society.