Annex 1

Applications of the approach

The two studies that follow explore retrospectively how the questions from the spiral model of the systems approach could have been applied (Section 5: A framework for action) to the development and deployment of:

The Esther Model of care for elderly persons with complex care needs

— a multi-organisational collaboration between acute, primary and social care providers was created by Jönköping County Council to develop a model for the improvement of patient-centred care in the community, based on a fictitious patient known as Esther (see also Case study 1: Esther Model).

Safer care for patients using oral methotrexate for the treatment of rheumatoid arthritis

— local and national stakeholders, led by the National Patient Safety Agency (NPSA), were engaged in making the design of methotrexate tablets and their prescription, delivery and monitoring safer for patients (see also Case study 2: Oral methotrexate).

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