标题：Improving Care and Service Coordination for Vulnerable Populations Through Collaboratives: One Funder’s Approach, Impact, and Implications for the Field
摘要：· Improvement collaboratives are short-term learning systems that bring together teams from multiple organizations to seek improvement on a focused topic within the organizations. Most commonly applied in clinical settings, improvement collaboratives are less frequently applied in social-service settings or across agencies to support coordination of care and services for vulnerable populations. · This article describes findings from four collaboratives conceived and funded by the Health Foundation for Western & Central New York. It examines the foundation’s collaborative structure (a modified Breakthrough Series model in which health and social-service organizations work together in multi-agency teams to implement best practices and improve coordination of services for vulnerable populations), along with the impact of each collaborative on learning, communication, participating organizations, and target populations. · Reports from 91 participating organizations, representing 50 teams, in four collaboratives revealed strong team achievement, learning and communication, and sustained improvements. Impacts on target populations and spread of best practices were also reported. A key influence on achievement was the use of multi-agency teams representing two or more organizations working together to implement new processes and improvements to support patient handoffs across health and social service settings. · Findings suggest that the foundation’s collaborative model – an adaptation of the intra-organizational Breakthrough Series model for use in amulti-organizational setting – can be effective in fostering improvement within organizations and promote coordination across agencies to improve health and social services for vulnerable populations. Collaborative structure and process recommendations for funders interested in this model are highlighted.
关键词：Breakthrough Series Collaborative model; multi-agency teams; improvement; care and service coordination; care transitions; vulnerable populations
