Understanding The Process Develop Model Care
Understanding The Process Develop Model Care
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TABLE OF CONTENTS
INTRODUCTION......................................................................................................................... 2
Purpose...............................................................................................................................................................................2
Background.........................................................................................................................................................................2
Guiding principles...............................................................................................................................................................3
What is a MoC?..................................................................................................................................................................3
Developing an MoC............................................................................................................................................................3
The process.........................................................................................................................................................................4
Clinical program design and implementation (CPD&I) team support...................................................................................4
GEM e-Learning portal........................................................................................................................................................4
PHASE 2 – DIAGNOSTIC............................................................................................................. 8
2.1 Define the problem..................................................................................................................................................... 8
2.2 Understand the “as is”............................................................................................................................................... 8
2.3 Establish data and information sources....................................................................................................................... 8
2.4 Literature review of evidence-based practice and innovation....................................................................................... 9
2.5 Finalise the case for change........................................................................................................................................ 9
2.6 Identification and prioritisation of issues..................................................................................................................... 9
2.7 Examples of work already completed.......................................................................................................................... 9
PHASE 4 – IMPLEMENTATION................................................................................................... 14
4.1 Define the change.................................................................................................................................................... 14
4.2 Self assessment/gap analysis..................................................................................................................................... 14
4.3 Develop the business case and seek endorsement.................................................................................................... 14
4.4 Generate sponsorship for implementation and governance structure........................................................................ 15
4.5 Build frontline capacity and engagement.................................................................................................................. 15
4.6 Communications plan............................................................................................................................................... 15
4.7 Implementation plans/reinforcement strategies......................................................................................................... 15
PHASE 5 – SUSTAINABILITY...................................................................................................... 16
5.1 Ongoing monitoring, continuing local focus and accountability................................................................................ 16
5.2 Review and optimise the MoC.................................................................................................................................. 16
5.3 Final evaluation......................................................................................................................................................... 16
5.4 Knowledge management......................................................................................................................................... 16
Purpose
The aim of this document is to be a reference point for the Agency for Clinical Innovation (ACI) staff when
developing Models of Care (MoC). The document outlines the key processes required to develop a MoC. It is
acknowledged that developing a MoC will vary greatly depending on the size of the project and the subject area.
ACI staff will also bring different skills and expertise, all of which are needed to contribute to the development
of the model. This document offers guidance to assist the development of a MoC. Each project will have its own
unique elements and the guidance will need to be applied slightly differently to each. Some of the ACI human
resources that can assist with developing a MoC are outlined in this document. These guidelines are intended to act
as a reference or guide throughout this process.
Background
The ACI has an extensive network of clinicians and a wealth of clinical expertise. The vision of the ACI is to be
valued as the leader in the health system for designing and supporting the implementation of innovative models of
patient care.1 The concept behind the ACI Clinical Networks is that the knowledge needed and the best innovations
will come from front line clinicians working in the NSW Health system. This document provides a framework for
developing clinician’s ideas into an evidence based, implementable MoC. The process described in this document
should be managed by the ACI, but the ownership and creative process belongs to the networks and their
members. In this way, the end result will be owned by front line clinicians, creating a better product and making it
easier to implement.
Developing a MoC will require a wide range of skills, expertise and processes which include: clinical expertise,
2 Understanding the process to develop a Model of Care in the ACI
communication skills, financial, research, economic & data analysis, evaluation and project management skills. It
will be important to leverage these skills early in the development phase of the MoC. Within the ACI team there is
a wide skill set to enable the team to develop innovative MoC in collaboration with clinicians, patients, health care
partners and the community.
Many of the ACI Networks also work on developing clinical guidelines and although they are different to a MoC,
placing a greater focus on clinical practice rather than the delivery of health services, many of the principles in this
document will also be useful when producing them.
Factors for consideration when you are developing a MoC are that:
• it is based on the best available evidence
• it links to strategic plans and initiatives (local, national, state)
• it is developed in collaboration with clinicians, managers, health care partners, the community, and with patients,
their carers, and or organisations that represent them
• costing, funding and revenue opportunities for the MoC are identified, and assessed
• it extends across the patient journey through different care providers
• specialty and priority populations of patients have been considered
What is a MoC?
A “Model of Care” broadly defines the way health services are delivered. It outlines best practice care and services
for a person, population group or patient cohort as they progress through the stages of a condition, injury or event.
It aims to ensure people get the right care, at the right time, by the right team and in the right place2.
Developing a MoC
When designing a new MoC, the aim is to bring about improvements in service delivery through effecting change.
As such creating a MoC must be considered as a change management process. Development of a new MoC does
not finish when the model is defined, it must also encompass implementation and evaluation of the model and the
change management needed to make that happen.
Developing a MoC is a project and as such should follow a project management methodology. This document uses
the ‘Redesign Methodology’3 to manage the project of developing a MoC.
4 https://gem.workstar.com.au/public/index.cfm?action=login&returnTo=/
The aim of this phase is to develop a clear understanding of what your project is and how you plan to tackle all of
the issues that may arise.
The end users of any MoC will be clinicians and their patients. Throughout the development of the MoC, care
providers, patients/carers and or organisations that represent them should not only be consulted, but should part
of the team developing the MoC. Front line staff, patients/carers and or organisations that represent them will
have the best knowledge and innovative ideas for how services can be delivered. In addition, if clinicians are
involved in developing the MoC then they will have ownership of the changes to their services. Patients and their
carers and or organisations that represent them will provide valuable expertise, insight and experience into
current services and should be actively engaged in all the phases of the MoC development.
The earlier that clinicians and patients/carers and or organisations that can represent them are involved in the
project, the higher the likelihood of creating successful change will be. At this stage it should be established
whether this is a project that will have value for them. Do they consider it an area of priority? If it is not an area
of priority for front line staff and patients, should we be investing resources in this area?
The aim of this phase of the Redesign methodology is to take the prioritised issues from the diagnostic phase and
develop a range of solutions that address the problem.
P roblem solving is the stage when thinking moves from analytical to creative,
Problem Solving
generating a large number of potential solutions.
The aim of this phase of the methodology is to change current practice to the new MoC. The link must be made
between the system changes that will occur, and the behaviours changes that are needed to make this happen. This
phase of developing a MoC is the most resource intensive phase.