Anne Veil

Evaluation of the Implementation of PRISMA, a Coordination‐Type Integrated Service Delivery System for Frail Older People in Québec

PRISMA is the only example of a co‐ordinated‐type model to be developed and fully implemented with a process and outcome evaluation. The PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and an implementation evaluation was carried out using mixed (qualitative and quantitative) methods. Over four years, the implementation rates went from 22% to 79%. The perception of integration by managers and clinicians working in the various organisations of the network shows that most interactions are perceived as at the co‐operation level, some getting the highest collaboration level. The perception of the efficacy of case managers was very high. Implementing such a model is feasible, and the decision to generalise it was made in Quebec. This model might be more appropriate for a universal publicly funded health care system like those in Canada, the UK and the Scandinavian countries.

How Can a Research Program Enhance a Policy? AFC-Quebec Governance and Evaluation Opportunities

This chapter outlines the progress of the AFC-QC projects, as well as a few lessons learned both in developing and evaluating the program. In order to do this, we first describe the program’s approach since the beginning of AFC-QC with 7 pilot sites, between 2008 and 2013, in line with the work of the WHO (2007a), until the introduction of an AFC governmental program in 2009. Since then, more than 750 municipalities in Quebec have joined the AFC-QC. Then we demonstrate how this governmental program was jointly built with the planning research over a period of 8 years (2007–2015). The research team, under the direction of Suzanne Garon, has been mandated for the evaluation of 7 pilot projects. Designed on the basis of previous experiences, two other projects are in progress (2014–2017), allowing the use of action-research methods that pave the way to learning process and co-construction. Finally, we explain how the various evaluation models reflect the positioning of the evaluator who acts in the interests of consistency with the project guidelines. Stakeholders continue to evolve (government, communities, trainers, researchers and seniors) in the light of knowledge accumulated over the years and of shared experience in changing contexts.