The appropriate scale for integrated care: a continuous and ongoing search

Organizing integrated care in networks of collaborating care organizations is a complex challenge. One of the aspects of this challenge concerns determining the suitable scale of such networks. The aim is to provide the participants with knowledge and tools in order to make more deliberate scale-decisions. Context & research problem: Scale is not a simple question of macro/meso/micro but an outcome of the interplay between many different interests, values and perceptions of organizations participating in a network. Our research project indicates that scale of networks can be analyzed by regarding several frames/dimensions, such as target group of a network, relevant business models behind the network or historical relations among the participants. Due to different positioning of members of integrated networks regarding these perspectives, the question ‘which scale is suitable’ can be answered in different ways. At Vilans, we have been researching this question for several years now and we have developed knowledge and tools aimed to help integrated care networks to find their suitable scale. We are also monitoring and researching integrated care networks that have been using our knowledge and tools, in order to receive feedback and to improve our tools and both strengthen and deepen our knowledge position. Our primary target audience consists of long-term care professionals involved in integrated care networks, for instance in a role as network coordinator. But also, managers, directors and executives who have to make choices and decisions concerning the integrated care networks in which their organization might participate. Facilitation of the workshop: The workshop will be facilitated by Marloes Berkelaar, senior advisor and Sander Merkus, senior researcher, both working at Vilans. Professor Mirella Minkman of TIAS/Tilburg University will also be present. They will be accompanied by Carole Groenescheij, who is an independent organizational advisor focused on facilitating integrated care networks. We aim to check and validate our initial findings and we aim to practice with a practical instrument or tool based on these findings. Following an introduction about scale of integrated care (10 minutes), we will present a case study example, in which the independent organizational advisor will explain how she has used the Vilans scaling knowledge and tools to determine the appropriate scale of the integrated care network, in co-creation with its members (15 minutes). After this example, we will engage in interactive discussion with the audience (30 minutes). In smaller groups, participants will reflectively practice with the scale tool in their own (national) context, each supported and guided by one of the facilitators of the workshop. The key learnings for participants would be an increased sensitivity and consciousness for matters of scale in integrated care networks, and a useful framework which they can use to reflect on appropriate scale of the integrated care network in which they are involved. This is a valuable process, not only when designing the integrated care network at the start, but also during major developments and changes of the network.