Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis.
Esther Suter, Nelly D Oelke, Maria Alice Dias da Silva Lima, Michelle Stiphout, Robert Janke, Regina Rigatto Witt, Cheryl Van Vliet-Brown, Kaela Schill, Mahnoush Rostami, Shelanne Hepp, Arden Birney, Fatima Al-Roubaiai, Giselda Quintana Marques
Author Information
Esther Suter: Faculty of Social Work, University of Calgary, CA.
Nelly D Oelke: School of Nursing, University of British Columbia, Okanagan (UBCO), CA.
Maria Alice Dias da Silva Lima: School of Nursing, Universidade Federal do Rio Grande do Sul (UFRGS), BR.
Michelle Stiphout: Workforce Research and Evaluation, Alberta Health Services (AHS), CA.
Robert Janke: University of British Columbia, Okanagan (UBCO), CA.
Regina Rigatto Witt: School of Nursing, Universidade Federal do Rio Grande do Sul (UFRGS), BR.
Cheryl Van Vliet-Brown: School of Nursing, University of British Columbia, Okanagan (UBCO), CA.
Kaela Schill: School of Nursing, University of British Columbia, Okanagan (UBCO), CA.
Mahnoush Rostami: Workforce Research and Evaluation, Alberta Health Services (AHS), CA.
Shelanne Hepp: Workforce Research and Evaluation, Alberta Health Services (AHS), CA.
Arden Birney: Workforce Research and Evaluation, Alberta Health Services (AHS), CA.
Fatima Al-Roubaiai: British Columbia Patient Safety and Quality Council (BCPSQC), CA.
Giselda Quintana Marques: School of Nursing, Universidade Federal do Rio Grande do Sul (UFRGS), BR.
BACKGROUND: Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care. METHODS: We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools. FINDINGS: From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains. DISCUSSION: Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, "overall integration" tools may be useful for a broad assessment of the overall state of a system. CONCLUSIONS: Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.
