Design Care Delivery Transformation
What does it mean to design a care delivery transformation, and why is it important?
Designing a care delivery transformation means creating an intervention that directly addresses the root causes of health inequities that you identified and prioritized for intervention. A strong design improves outcomes, centers the input of patients living with the inequities, supports sustainability, and stays aligned with your equity goals. This step turns insights into action, restructuring healthcare systems to eliminate disparities and improve outcomes for all.
By this stage, your team has already:
- Started building a culture of equity
- Identified a health equity focus
- Diagnosed the root causes behind that focus
- Prioritized which root causes to address
The chart below details the steps as well as the approximate number of meetings for which to plan, while recognizing that the estimates will vary from team to team.
| Key Activities | Time Est.: ~13+ Hours |
|---|---|
| Review the results of your root cause analysis and priority matrix | 1 one-hour meeting |
| Map the prioritized root causes to the levels of the care delivery system to determine which level(s) your care transformation will prioritize | 1 one-hour mtg |
| Identify/build interventions for each of the levels * Identify the ideal strategies and how the strategies will be employed (i.e., mode of intervention). | 1-3 one-hour mtgs |
| Explore the roles of different stakeholders in interventions and how to earn their buy-in * Consider using the Stakeholder Identification and Action Planning Tool | 1-3 one-hour mtgs |
| Present your proposed care delivery transformation to leadership, staff, and patients living with the inequities and get their feedback before your design is final. * Attempt to include at least some root cause analysis participants | 3-5 one-hour mtgs |
| Present plan to each implementation stakeholder group for review and approval * Ask them to identify potential implementation challenges. | 3-5 one-hour mtgs |
| Anticipate and plan for unexpected implementation challenges and opportunities * Consider using scenario planning resources | 3-4 hours total (1+ mtgs) |
How and when should I design a care delivery transformation?
Designing care transformations to eliminate inequities is a multi-step process that requires structured planning and input from diverse voices. Start by carefully reviewing the Design Care Delivery Transformation presentation below with your team, allowing plenty of time to review and discuss the information. Next, begin designing your care delivery transformation by reviewing Recommendations for Designing Equity-Focused Care Delivery Transformations as a team and using it to guide your work.
Review the report Designing and Implementing Integrated Care and Payment Transformation Initiatives to Advance Health Equity: Lessons Learned from Three Pioneering Health Care Provider and Health Plan Partnerships to see examples of care transformation models designed and implemented by others; page 13 outlines the lessons learned about the process.
Don’t forget to use your priority matrix to align your care transformation with the identified root causes. It’s easy to fall into a trap of reverting to care models that you are familiar with or those which are easier to implement. That may be easier and faster than designing a care model tailored to the results of your root cause analysis, but it will significantly decrease your chances of success.
Engage frontline staff, patients, and community partners throughout the process to ensure the design stays relevant and sustainable. Create logic models and map patient journeys and care delivery processes to anticipate barriers and leverage existing systems to create changes that are both impactful and achievable.
Resources to Design a Care Delivery Transformation:
Design Care Delivery Transformation
This presentation introduces teams to the process of translating prioritized root causes into care transformation interventions by applying a levels, strategies, and modes framework. This framework helps identify who is impacted by the care transformation, what strategies to use, and how to implement them. It also addresses common implementation barriers such as limited resources, organizational culture, and stakeholder buy-in; it also offers practical strategies for navigating those barriers.
Breathe Easy Narratives
The Breathe Easy Narratives document contains three fictional, character-driven vignettes grounded in real health disparity data, designed to support small group discussion and applied learning. Each story invites participants to explore root causes of health inequity and practice designing equity-focused care delivery transformations.
Recommendations for Designing Equity-Focused Care Delivery Transformations
This resource provides recommendations and outlines activities that organizations can implement to design their own equity-focused care delivery transformations.
Designing and Implementing Integrated Care and Payment Transformation Initiatives to Advance Health Equity: Lessons Learned from Three Pioneering Health Care Provider and Health Plan Partnerships
Sometimes it is helpful to learn from the experiences of others. This report presents case studies of care and payment transformation models designed and implemented by three pairs of health care provider and health plan partnerships to advance health equity. See page 13 for important lessons that they learned about the process of designing a care delivery transformation.
Assessing the Process of Designing a Care Delivery Transformation
The prompts in this resource will help teams:
- Align the care transformation with root causes
- Improve participation in designing the care transformation
About the Roadmap Goal and Objective Setting Tool
Use the Roadmap Goal and Objective Setting tool to facilitate and document the development, implementation, and evaluation phases of your health equity initiative. It will help your team realize your vision to reduce and eliminate health and healthcare inequities by providing a centralized resource to:
- establish process goals that align with each Roadmap component;
- document task status, identify project champions, and maintain detailed notes;
- monitor progress across multiple Roadmap components simultaneously; and
- promote consistent team communication, accountability, and progress.