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