Flexibility in rigid systems: a meta-synthesis of best practices for integrated care.

Abstract

Integrated care has the potential to mitigate patient safety risks by enhancing collaboration and maintaining a patient-centred approach. However, best practices for successful implementation are lacking. This study aims to identify and describe key components of best practices for integrating health and social care to increase understanding of successful implementation. A Collaborative Reflexive Deliberative Approach was used. The data comprised twenty-one published articles and five unpublished manuscripts from 2015 to 2023, along with the experiences of ten clinicians and researchers in integrated care, and the research team itself. Components identified as best practices for integrated care, each describing different aspects shaped by and for the patient, were: holistic co-creation in an ethical stance, trust through physical and relational proximity, flexible caring, learning and adaptable organizations and flexible information and communication. The study emphasizes the importance of building trust through proximity and adaptable organizational learning, and the need for a holistic perspective, acknowledging both the limitations and potentials of health and social care integration. Embracing innovative thinking and recognizing that not everyone needs all services at all times can foster flexible, person-centred integrated care. Addressing these complexities is essential for successful integration efforts.