Figure 1
Four-stage Delphi study methodological process including nine evaluation points recommended by Nasa et al. [16].
Table 1
Demographic characteristics of the Delphi study panellists (n = 21).
| CHARACTERISTICS | TOTAL | |
|---|---|---|
| Gender | Male | 10 |
| Female | 11 | |
| Country of employment | United Kingdom | 7 |
| Netherlands | 3 | |
| Australia | 3 | |
| Austria | 2 | |
| Argentina | 1 | |
| Canada | 1 | |
| Germany | 1 | |
| Ireland | 1 | |
| Spain | 1 | |
| United States | 1 | |
| Type of employment organisation* | University | 18 |
| Hospital | 4 | |
| Other | 10 | |
| Age | 50–59 | 10 |
| 40–49 | 6 | |
| 60–69 | 3 | |
| 30–39 | 2 | |
[i] * Multiple responses possible. (Other – TAFE, research institute, community organisation, government organisation, not for profit organisation, professional society).
Table 2
Characteristics of IC training.
| CHARACTERISTICS | TOTAL | |
|---|---|---|
| Training* | Undergraduate | 4 |
| Postgraduate | 16 | |
| Other | 5 | |
| Target participants* | Existing healthcare workers | 10 |
| Healthcare managers | 9 | |
| Community organisations | 7 | |
| Mode of delivery* | Short course (face to face) | 7 |
| Blended | 3 | |
| Online | 6 | |
[i] * Multiple responses possible.
Table 3
Final framework (Framework B).
| Domain 1: Person-centred care |
| 1. Shared identification of the strengths and needs of individuals involving carers and families to improve quality of care, health outcomes and well-being. |
| 2. Developing a comprehensive understanding of individuals’ needs, including their health literacy, individual goals and how these can be met within their surrounding health and social care environment. |
| 3. Improving individuals’ and carers’ knowledge, skills and confidence in navigating the health and social care system. |
| 4. Facilitating people becoming empowered to participate in their own care, building on their strengths and capabilities. |
| 5. Ability to actively involve and support carers, helping them to understand and participate in care and recognising and responding to signs of carer distress. |
| Organisation focused |
| Domain 2: Interprofessional teamwork and collaborative practice |
| 6. Working effectively as a team member across a range of disciplines and settings. |
| 7. Collaborating with service providers within the acute, primary, and informal care sectors. |
| 8. Sharing information and data across teams and service providers and with individuals and their families. |
| 9. Demonstrating well-developed negotiation skills within teams, across services and with others in the network of care. |
| Domain 3: Care coordination |
| 10. Adopting a care coordination role, including effective communication with people/carers and service providers to improve the experience of health and social care. |
| 11. Demonstrating the ability to coordinate care within a complex system. |
| 12. Demonstrating knowledge of local and national policy and programs and communicating these programs to others. |
| 13. The capacity to identify and collaborate with a range of professionals and key partners based on the needs of the individual, population or community. |
| Domain 4: Digital skills and technology |
| 14. The ability to use a range of technology to support care coordination. |
| 15. Demonstrating the use of digital literacy across a broad range of settings. |
| 16. Engaging patients and families through technology-based communication tools to support their integrated care. |
| 17. Utilising linked datasets and population health management tools to analyse data and identify trends to inform and evaluate integrated care. |
| 18. Using shared electronic patient records to enhance communication and collaboration with service users and their families. |
| Operation focused |
| Domain 5: Health promotion and disease prevention |
| 19. Facilitating behaviour change in individuals, families and communities to achieve ways of living that promote health, resilience, well-being and disease prevention. |
| 20. Obtaining an integrative history that includes health and nutritional status, functional ability, housing and social circumstances, wellness strategies and use of conventional medicines and complementary therapies. |
| 21. Knowledge of local community resources and preventative programs to support people and communities to make healthy choices. |
| 22. Providing education on self-care strategies for maintaining good health and incorporate these strategies and resources into all care plans. |
| Domain 6: Population health approach to care |
| 23. Identifying and addressing the needs of local communities by understanding the available resources, population data, and gaps that may exist in healthcare delivery. |
| 24. Demonstrating knowledge of local, national and international population health strategies and programs, and understanding when and how to access these services to support health and wellness. |
| 25. Understanding how to navigate system complexity across population health programs and service providers to enable integrated care. |
| 26. Identifying and referring vulnerable populations and those experiencing health inequalities to appropriate support programs, to plan and deliver effective care at a population level. |
| 27. Understanding the social determinants of health such as housing and employment and how these impact population health outcomes to support integrated care. |
| Practitioner attributes |
| Domain 7: Leadership |
| 28. Developing as leaders, role models and local champions to advocate for integrated governance and support implementation of integrated care. |
| 29. Demonstrating leadership in influencing other professionals and service providers to be more person-centred and collaborative in their practice. |
| 30. Facilitating opportunities for shared learning and innovation across disciplines, providers and partners to encourage reform and new ways of working. |
| 31. Creating a safe space to constructively challenge the practice of others to ensure the delivery of person-centred care. |
| 32. Implementing shared governance between multi-stakeholders and sectors. |
| 33. Enabling and creating opportunities for systems thinking and change together with service providers and people with lived experience to improve healthcare delivery and outcomes. |
| 34. Using evaluation and research methods including lived experience to drive change and improve services. |
| Domain 8: Professional and ethical attributes |
| Members of our health and social care workforce need to be seen as role models. They need to demonstrate the following professional and ethical practitioner attributes: |
| 35. practising and integrating self-care strategies |
| 36. engaging in continuous learning, supervision and maintaining evidence-informed practice |
| 37. becoming mentors, teachers and peer learners |
| 38. showing empathy and emotional intelligence |
| 39. practising reflective thinking and learning |
| 40. demonstrating competencies in working with difference (cultural, social and neurodiversity). |