Transforming towards sustainable health and wellbeing systems - Eight guiding principles based on the experiences of nine Dutch Population Health Management initiatives

IntroductionPopulation Health management (PHM) initiatives are increasingly introduced, aiming to transform towards sustainable health and wellbeing systems. However, the struggling with this development. In order be able act upon complexity of such system change, understanding which strategies implement at moment development would valuable. Based on experiences nine Dutch PHM initiatives, study provides guiding principles insights into use, why, when.Methods We used realist evaluation approach for relationships between context, mechanisms outcomes when were implemented. Data was based quarterly updates developments three interview rounds 2014 2017 different stakeholders from care, social public health, community , education, business (n=207). Strategy-context-mechanism- outcome configurations coded clustered within Collaborative Adaptive Network (CAHN) framework development.Results in across cases, eight identified, focusing on: 1. Shared commitment a PHM-vision; 2. Mutual trust; 3. Accountability; 4. Aligning politics policy; 5. Financial incentives; 6. A learning cycle data-infrastructure; 7. Community input involvement; 8. Stakeholder representation leadership. DiscussionsThe line themes international literature, additionally provide detailed knowledge links strategies, contexts they implemented in, that triggered its’ outcomes. Furthermore gained especially relevant during first phases development.Conclusion Developing systems is experienced as complex time-consuming. The success influenced by implementation all principles, well applying right Lessons learned• vary their progress due used.• Eight reveal when, why how strategies.• Commitment, trust leadership main importance phases.LimitationsAs current have not yet fully developed systems, Several further hereby base future research uncovering suitable these contexts.Suggestions researchIn mainly CEO level representatives retrieved. Little been retrieved health-care care professionals or citizens themselves. we expect delegated high relevance. Therefore additional will