Table 2 Organizational analysis framework for health centers integrating the BPS approach (Adapted from Jenna's CCIC Framework) (Â 27)
Component | Definition | Subcomponents applied to HC | Link to BPS approach for HC |
|---|---|---|---|
Basic Structures | |||
 Physical Features | Structural and geographic characteristics of the organization/practice and network | Appropriate consultation room, availability of staff | Ability to respect the confidentiality and privacy of patients guaranteed in the consultation room |
 Resources | Availability of tangible and intangible assets for ongoing operations at the organization/practice and for network activities | Availability of means to organize the supply of care | Capacity to mobilize resources to implement the BPS approach |
 Governance | How the board or steering committee is organized and its activities to direct, manage and monitor the affairs of the organization/practice and network | Experience sharing, communication on service management | Ability to implement a better organization of services integrating the bio-psychosocial aspects of care |
 Accountability | The mechanisms in place to ensure that people and organizations meet formal expectations in the organization/practice and network | Supervision of health centres by the Health Zone Management Team and partners, functioning of the health committee | Capacity for accountability and supervised responsibility of the health center team in the implementation of approaches, including BPS |
 Information Technology | The availability and ease of use of technology-based communication and information storage mechanisms in the organization/practice and across the network | Community members’ Patient record, Computerization of personal data | Ability to collect information on the biomedical, psychological and social characteristics of community members |
 Organizational / Network Design | The arrangement of units and roles and how they interact to accomplish tasks in the organization/practice and network | Communication for coordination and continuity of care, existence of community support groups | Ability to organize continuity of care and psycho-social support for patients at community level |
People and values | |||
 Clinician Engagement & Leadership | The formal and informal roles held by clinicians in the organization/practice and network, particularly physicians, that enable them to buy-in to and steer change, and influence others | Mentoring of health center teams by doctors from the Health Zone on the BPS approach | Ability to influence change, by promoting the practices of caregivers and the exchange of information between the HC and the general referral hospital for a better management of BPS issues |
 Organizational / Network Culture | Widely shared values and habits in the organization/ practice or network | Shared definition of the BPS approach within the team; shared vision and values about patient-centered care and the BPS approach | Ability to structure the care offer according to the BPS approach, influenced by the values and habits of the care teams |
 Focus on Patient-Centeredness & Engagement | Commitment to placing patients at the center of clinical, organizational and network decision-making | Taking into account patients' impressions and preferences in the organization of care | Ability to integrate patient preferences into the provision of care, using the BPS approach |
 Commitment to Learning | The existence of a set of values and practices that support ongoing development of new knowledge and insights within the organization/practice and network | Promotion of new practices, participation in training sessions and case discussions | Ability to implement new practices including those related to the BPS approach |
 Work Environment | How employees perceive and experience their job and their workplace in the organization/practice and network | Collaboration between team members, Job satisfaction | Ability to organize collaborative, interdisciplinary and multidisciplinary work compatible with the BPS approach |
Key processes | |||
 Partnering | The development and management of formal and informal connections between different organizations/practices | Sharing of experiences and personnel, Referrals of people and sharing information | Ability to interact with formal and informal partners to strengthen the implementation of the BPS approach |
 Delivering Care | The methods used by providers in caring for patients in the organization/practice and network | Use of flowcharts in care and the BPS model, nature of patient-caregiver relationships | Ability to structure the provision of care according to the BPS approach and to support it with tools based on scientific evidence, ability to build better patient-caregiver relationships |
 Measuring Performance | The systematic collection of data about how well the organization/practice and network is meeting its goals | Measurement of indicators, Preparation of regular reports (timeliness and completeness), Access to data | Ability to measure the performance of the health care offer according to a BPS approach, to document the events and practices related to this approach in order to improve and achieve objectives |
 Improving Quality | The use of practices and processes that continuously enhance patient care in the organization/practice and network | Improving the quality of care, Application of best practices | Ability to manage change to improve the quality of care delivery using the BPS approach |