Drivers of successful implementation of integrated care for multi-morbidity: Mechanisms identified in 17 case studies from 8 European countries

This paper provides a deeper understanding of the mechanisms underlying implementation strategies for integrated care. As part SELFIE project, 17 care programmes addressing multi-morbidity from eight European countries were selected and studied. Data was extracted ‘thick descriptions’ analysed both inductively deductively using theory. The following ten successful identified. With regards to service delivery, implementers (1) commonly adopted an incremental growth model rather than disruptive innovation approach, found (2) balance between flexibility formal structures integration. For leadership & governance, they (3) applied collaborative governance by engaging all stakeholders, (4) distributed throughout levels system. workforce, these (5) able build multidisciplinary team culture with mutual recognition each other's roles, (6) stimulated development new roles competencies respect financing, (7) secured long-term funding innovative payments as means overcome fragmented financing health social Implementers emphasised (8) ICT that specifically developed support collaboration communication administrative procedures (technology medical devices), (9) created feedback loops continuous monitoring system (information research). overarching mechanism (10) engaged in alignment work across different components These evidence-based are applicable local, regional national contexts.