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IntroductionIntegrated health and social care is a policy priority in Catalonia. During COVID pandemics impact in care home has been huge in terms of incidence, hospitalization and death. Mortality in care home related to COVID has been in Catalonia 40% of all deaths related to COVID In global population. There have been a great effort of all health and social care system to give appropriate response to severe situation in care homes. Integrated Care approach has been an essential key component in the model of care as both Health Care and Care Homes are responsibilities taken by different ministries.Aims Objectives Theory or MethodsObjectives: 1) Evaluate the current maturity level of and readiness for integrated care in care homes in different territories in Catalonia. 2) Assess the current situation that allows identifying breeding lines for the updating and progress in IC model in care homes. The SCIROCCO Exchange self-assessment tool (see: https://scirocco-exchange-tool.inf.ed.ac.uk/en_gb/) is a self- assessment tool to assess a region’s readiness and maturity for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing.190 professionals from 18 regions were assessed.Highlights or Results or Key FindingsRelatively low scores in all 12 dimensions in SCIROCCO maturity model. Remarkable increase in 2021 scores compared to the pre-pandemic situation scores. Territorial differences exist even if rurality does not seem to be a determinant factor in IC in care homes maturity.“Structure and governance” and “Breadth of ambition” among the highest rated SCIROCCO dimensions and “Funding” and “Evaluation methods” among the lowest rated in both individual self-assessments and consensus self-assessments.“Structure and governance” and “Breadth of ambition” among SCIROCCO dimensions that increase the most their scores in the current situation compared to the pre-pandemic situation.Some valuable qualitative information is identified as areas to be improved: need of better labour conditions, need of a share and integrated health and social information and interoperable health and care record, need of incorporating a more systemic and comprehensive perspective with demographic segmentation and stratification approach. Theses qualitative information will be incorporated in updated IC model.ConclusionsBefore pandemics, development of Integrated care in residential care has been scarce. During pandemics, Integrated Care approach has been adopted both at ministries level and regional level implementing a range of Integrated Care initiatives to cope with vulnerable situation of people living in care homes in Catalonia. Implications for applicability/transferability sustainability and limitations Integrated Care policy and action in care homes should be maintained overtime and reinforced in last stage of pandemics to create a scenario of collaborative work and transformation in residential care. IC should be incorporated in other long term care policies (home care,...) in new updated design and implementation.

IntroductionThere is small knowledge in the literature related to people with Home Healthcare (HHC) and Social Home Care (SHC) in the community. Both HHC and SHC are responsibilities and activities performed by different Ministries and Local Government. Very few tools facilitate collaborative practice between different professionals teams and services working in the home care area. Aims Objectives Theory or MethodsObjectives:-Analyse and describe population with both Home healthcare and Social home care services-Analyse impact of Integrated Home Care services in population living at home requiring home care servicesMethods:→ PHASE 1: Analysis of the level of deployment and degree of achievement of key contents related to a model of integrated care for the different regions of Catalonia: unique shared assessment instruments, individual single care plan, shared protocols. → PHASE 2: Evaluate the impact of healthcare on adequacy of use and demand, efficiency and capacity; with indicators of use of services, such as hospitalizations, institutionalization and primary care useHighlights or Results or Key FindingsAggregate average score of each of the indicators used in the analysis of the baseline situation of the Integrated Care in home care services was 1.4 out of 5, representing 27.5% of the maximum score.Integrated Home Care decreases the probability of being institutionalized in a nursing home by 20% and decreases the number of cumulative days of hospitalization in health centres by 2.3%. Primary care visits increases by 2.1%, 6.4% in the case of home healthcare visits and 3,2% virtual visits. No significant impact on hospital admissions was observed. Integrated Home Care implies that overall increase in social and health spending decreases by 2.2%. There is no significant variation in health expenditure, as the increase in community and outpatient health expenditure by 3.8%, compared to the decrease in inpatient health expenditure (hospitals and social health). There is a significant impact on the increase in social spending by 16.8%.ConclusionsAmong the most valued elements: lack of protocols, culture of little coordination between health and social care, high demanding situation, perception of deficit of political mandate, lack of shared information systems and scarcity of professionals. Among most mentioned facilitating factors: good attitude and recognition of need of Integrated Care. Implications for applicability/transferability sustainability and limitations This experience of evaluating the impact of integrated home care is the first time carried out in Catalonia. There is a great challenge of overcoming the barrier in terms of data protection, in terms of work with aggregated health and social data, with highly explanatory potential use.

Aims and objectives. This study aimed to translate the community nursing version of the Developing Evidence-Based Practice questionnaire, adapt the Spanish translation to the primary care context in Spain, and evaluate its reliability and validity. Background. Instruments available in Spanish to date are not designed to rigorously evaluate barriers and incentives associated with evidence-based practice implementation in community health nursing. Design. Classical Test Theory approach. Methods. The 49-item Developing Evidence-Based Practice questionnaire was translated, back-translated and pilot-tested. Two items were added to assess respondents' ability to read and understand the English language. During the first six months of 2010, 513 nurses from 255 primary health care centres in Catalunya (Spain) voluntarily participated in the study. Internal consistency and test-retest reliability were evaluated. Internal structure was analysed by principal component analysis. A randomized, controlled, parallel-design study was carried out to test scores' sensitivity to change with two groups, intervention and control. The intervention consisted of eight hours of in-person training, provided by experts in evidence-based practice. Results. Of 513 nurses, 445 (86.7%) nurses responded to all 51 items. Factor analysis showed six components that explained 51% of the total variance. Internal consistency and test-retest reliability were satisfactory (Cronbach a and intraclass correlation coefficients > 0.70). A total of 93 nurses participated in the sensitivity-tochange tests (42 in the intervention group, 51 controls). After the training session, overall score and the 'skills for evidence-based practice' component score showed a medium (Cohen d = 0.69) and large effect (Cohen d = 0.86), respectively. Conclusions. The Developing Evidence-Based Practice questionnaire adapted to community health nursing in the primary care setting in Spain has satisfactory psychometric properties. Relevance to clinical practice. The Developing Evidence-Based Practice questionnaire is a useful tool for planning and evaluating the implementation of evidencebased practice in community health nursing.

It is well known in the literature how the modern health and care systems are being oriented to launch and develop national strategies to construct and build a more comprehensive system for the people with "complex health and social care needs". Most of Chronic Care programs have been introduced proactive care management for this vulnerable population who are causing high utilization of high cost services. However a new Integrated health and social care approach have been introduced in some countries and regions and there is a need of identifying these populations at risk with new and well accepted criteria and new care approaches in the field. This workshop will combine both the "policy and implementation in practice" related to proactive management of people with complex care needs from a joint health and social care perspective. 2 or 3 countries will be invited to explain main strategies and real implementation examples which could be easily escalated. An additional overview of Walter Wodchis as international expert and reviewer of different international national or regional best practices will be incorporated. We will introduce different issues related to complexity: - Earlier work of complex chronic health needs during implementation of Chronic Care programs. Some part of this work has started some time ago and experience of some yers could be - Evolution from the “complex health needs” toward a “complex health and social care needs” approach. New approaches to identify criteria related to complex social care needs will be explored especially related to the social care area. ·International overview of the most recognized innovative experience related to care for people with complex health and social care needs - "Terminology" required to talk properly about "complexity": complexity, complex care needs, multimorbidity, complex health and social care needs,...? - Complex care in practice approach explaining which strategy is being developed to take care of people with complex health and social care needs from an “individual, team and territorial (county)” perspective - ICT developments to support work with different organizations and professionals who work collaboratively to manage people under a "person centred model": introduction of Key Information Summary or Individual Intervention Plans to be shared by all organizations and professionals under a 24/7 scheme and other strategies - Evaluation approach of complex care strategy It would be introduced 2 or maybe 3 experiences and an additional international overview: - Catalonia and Scotland will talk about both policy and implementation in practice models which have priorised "complex care approach" - Walter Wodchis from Intitit oof Healt Policy, Management and Evaluation at University of Toronto speak about the most promising and innovative world experiences related to complex care (Walter Wodchis is co-author of the June issue of IJIC publishing 7 study cases related to complexity), showing lessons about these experiences and reccommendations for countries and regions developing and implementing Integrated Care for people with complex health and social care needs. This workshop will offer a combination of policy and implementation in practice issues and additionally an overview of the best practices in the world related to complex care