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Integrated People-Centred Health Systems (IPCHS) Standard
On this page
- Overview: the World’s First Integrated Care Standard
- Access the Standard
- About the IPCHS standard
- How to use the IPCHS standard
- Additional Information and Resources
- Implementation Tools that Support Adoption and Use
- Take Action with us
1. Overview: The World’s First Integrated Care Standard
We know how hard it is to translate the vision and value of integrated care into reality. We wanted to translate theory, evidence, and learnings from around the world into actionable best practices for integrated care. To offer concrete, evidence-informed guidance on what needs to be done and by whom to clarify accountability. To co-produce practical direction for systems change that could be adapted to local needs and contexts, not a one-size-fits-all prescription for change.
We know from our own on the ground experience in over 15,000 locations across 38 countries that people want change. Change that brings people together in new ways to build and support better systems of care – systems that are designed for and with those that need them the most. Systems that are people–centered, connected, safe and outcomes–oriented. In short, we need people-centered, integrated systems of care – everywhere.
Health Standards Organization (HSO) and our Integrated Health Technical Committee are proud to introduce the world’s first co-designed, evidence-based standard on integrated people-centred care and services: CAN/HSO 76000:2021 Integrated People-Centred Health Systems (IPCHS).
This standard is not currently a part of the Qmentum Accreditation or Distinction Programs.
2. Access the Standard
Click on the link to access the IPCHS standard on the e-store: CAN/HSO 76000:2021 Integrated People-Centred Health Systems (IPCHS)
3. About the IPCHS Standard
Why a standard?
Historically, a lot of focus was on the quality of services within organizations or within a specific sector or population. While essential to ensure quality and patient safety, focusing within the boundaries of one organization or sector is simply not enough. The evidence is clear: risks of adverse events are highest during care transitions and people with multiple health and social care needs frequently fall between the cracks of disjointed, provider-focused, and siloed care. The pandemic has put a spotlight on the limitations of our traditional health care systems in ways we had never imagined, and there is universal agreement that we must do better.
Standards can help bridge these gaps and address these unmet needs. Standards offer an agreed-upon way of doing things based on best evidence and consensus of experts. That is why we launched the process in the fall of 2017 to develop the world’s first standard for Integrated People-Centered Health Systems.
What does the standard address?
There are many definitions of integrated care – the one we use as the foundation for the standard is as follows: An in Integrated People-Centered health system is one with health and social services that are organized and managed across sectors and organizational boundaries so that people can receive coordinated and comprehensive services – at the right time, by the right provider in the right place.
The standard is structured around 10 design principles. These are the essential features that evidence from around the world and our consensus of experts say need to be in place for any integrated health system. We embedded expectations on partnering with people throughout every design principle, which is consistent with our HSO approach to all standards.
These 10 design principles for integrated people-centred health systems will help service planners and decision-makers move towards more integrated systems to:
- Improve population health,
- Provide better health care experiences,
- Increase engagement for clients and providers,
- Reduce the costs of care, and
- Improve the quality and safety of care.
To make the standard relevant and actionable in the real world, each design principle sets out explicit, objective requirements (criteria) to be met by health systems. The standard has 66 criteria in total that people can use as aspirational targets in their journey toward a fully integrated health system. Guidance is available for each criteria to help policy makers and health system partners know what actions to take together as they set and advance their local priorities.
The 10 Design Principles of Integrated Care
4. How can I use the IPCHS Standard?
- A broad audience of individuals to come together,
- Have a shared vision,
- Knowledge and beliefs of what integrated care is, and
- Work together to achieve that vision.
This IPCHS standard is intended to be used by all audiences, together.
Here are some examples of ways people can use the IPCHS standard to address issues that are required for systems change:
1. Policy makers can use the IPCHS standard and implementation tools in their legislation or regulation as well as in guidance frameworks or national integrated care strategies and funding.
2. Health system partners (like service organizations) can use this standard to plan, deliver and optimize their systems of care. Their focus may include:
-Increased understanding of the population being served,
-Collaborating to design a common vision, and
-Establishing a shared governance structure.
For health system partners who are more advanced in their integration journey, attention may focus on:
-Evaluating team functioning and
-Optimizing interoperable information systems.
3. Providers can use the IPCHS standard and implementation tools to assist in their planning, delivery and evaluation of integrated people-centred care at the practice, network or system level as part of an interdisciplinary team.
4. Patients, Families and Caregivers will benefit from understanding what they can and should expect from the systems of care that they access in their local communities. Knowledge of the IPCHS standard can inspire participation in the journey toward integration as full partners. The philosophy of “nothing about me without me” is central to creating a truly people–centered, integrated care standard.
5. Researchers can use the IPCHS standard for clear, objective monitoring across networks and jurisdictions in their qualitative and qualitative studies. Implementation science and global organizations like the International Foundation for Integrated Care (IFIC) and the Organisation for Economic Co-operation and Development (OECD) can help advance use of measures and outcomes so that the impact and value of integration can be better understood.
5. Additional Information and Resources
Frequently Asked Questions: Please find an overview of some commonly asked questions related to system integration and the development of a standard.
Info sheet: learn about Health Standards Organization and Accreditation Canada’s current integrated care offerings, and considerations for users working in collaboration toward integrated people–centred health systems.
Client and family one-pager: Learn about the IPCHS standard and what to expect as a client or family member receiving integrated health services.
Continue learning: Review webinars and conference presentations related to integrated care.
6. Implementation Tools that Support Adoption and Use
Integration is a journey. Evidence suggests that systems typically go through five phases to transform into a fully integrated, people-centred health system. These phases start with the first level, described as co-existing, when organizations function as autonomous, independent organizations, often with no plans to change their service model. Transformation involves moving though the continuum into progressively more mature states of co-operation, collaboration and finally integration.
In the most mature state of integration, inter-dependent partners share structures, processes, resources and accountabilities to deliver team-based, coordinated services. The 10 design principles and 66 criteria in the IPCHS standard show people what this future state looks like in practical terms.
It is important to understand however, that networks and health systems may not aspire to or be able to achieve fully integrated care. And everyone gets to their destination at their own speed; transformation is not a linear process.
With this in mind, we set out to close the gap between design and practice. We wanted to help people apply the standard to create shared values and vision, and to enable people to move along the continuum at their own pace, and in a way that best suits their local context and goals.
The Improving Integrated Care for Youth (IICY) Initiative is a three-year program funded by the federal government that brings together six service networks from across Canada. Each network is applying the HSO standard within their local context. They are also working with experts, including our trained faculty, to co-design quality improvement tools and test those tools in real-life settings.
This innovative work involves 600 people, delivering care in 60 organizations across 11 Canadian provinces and territories. It allows us to learn in real-time through different geographies and populations, with differing levels of resources. Our collective aim is to drive sustainable improvements and better outcomes by integrating care for youth living with mental health and addictions conditions.
There are three Integration Implementation tools at various levels of development and testing:
1. The HSO Integrated Care Assessment Tool: Grounded in the HSO standard, this tool will help health systems understand where they are currently at on their journey towards integrated care. While the IPHCS standard informs what a fully integrated people-centred health system would look like, the Integrated Care Assessment Tool is designed to help health systems and networks understand how to advance on their journey and offers tangible next steps. It will provide users with an assessment of their health system’s current integration performance along each of the design principles in the IPCHS standard.
2. The Pathways Design Tool: Once systems understand their shared vision for integrated care, they need an approach that will help them get there. The Pathways Design Tool will help systems co-create integrated care pathways in partnership with patients and families to understand what change needs to happen on the ground to realize integrated care. Integrated care pathways are locally defined solutions that define the connections that are needed to connect people to the right services, in the right place at the right time.
3. A learning culture is essential for bringing integrated health systems to life. This project is using a variety of methods to build local capacity for integrated care, including learning collaboratives with peer-to-peer networking and mentoring, webinars, symposia and development of integrated people-centred leading practices. The tools and resources from these learning and knowledge exchanges will be adapted for use in other integrated health service settings over time.
As soon as we released the standard, people were asking for tools to help them get started on implementation. We know the above three tools will bring great value, especially when tested and evaluated in various settings.
That is where other partnerships come in, and we welcome people like you expressing interest in becoming an early adopter – using the standard and tools in your own setting and contributing to a global community of learning and innovation.
We expect the testing phase to continue over 2021, and then then tools will be released more broadly in late 2022.
7. Take Action with Us
This is your invitation to take action with us; let’s create positive change together. Please access the standard through our e-store. Test it out in your own network, talk about it with your colleagues and partners and let us know what you are learning through implementation.
Over the next several months, we will explore other countries and populations where the standard and implementation tools can be applied. If you are interested in partnering and becoming an early adopter, please contact us, we would be thrilled to have you join us in this journey.
Let’s move integrated people–centered care from design to practice.
Connect with us:
Access the IPCHS standard:
Click on the link to access the IPCHS standard on the e-store: CAN/HSO 76000:2021 Integrated People-Centred Health Systems (IPCHS).