- Systems engineering and abductive analysis, with co-creation using LEGO Serious Play, identified stakeholder needs and practical barriers to current MLTC care.
- Six design principles target service user and provider needs, mental health, cost considerations and system integration for improved MLTC care delivery.
- A novel service system architecture blueprint proposes integrated, equitable, holistic MLTC pathways spanning multiple clinical specialties and disciplines to improve outcomes.
Future Healthc J. 2026 Jul 7;13(3):100550. doi: 10.1016/j.fhj.2026.100550. eCollection 2026 Sep.
ABSTRACT
PURPOSE: To identify barriers and improvement opportunities for the effective management of care for people with multiple long-term conditions (MLTCs) and propose a service system architecture to ensure an integrated approach to achieving improved outcomes.
METHODS: A systems engineering process was used to derive stakeholder needs from multimorbidity case studies. An abductive analysis provided principles for system design. Hackathons using LEGO® SeriousPlay® helped co-create a service system architecture with patients and service providers.
RESULTS: Stakeholder needs captured through three metaphors (spaghetti, barriers, elephants in rooms) reflected concerns with current solutions; six principles for designing MLTC care services addressing service user and provider needs, mental health considerations, costs and system integration; and a service system architecture blueprint for MLTC care pathways.
CONCLUSIONS: The novel system architecture increases equality and equity and provides a framework for holistic MLTC care spanning multiple clinical specialties and disciplines.
PMID:42569157 | PMC:PMC13449361 | DOI:10.1016/j.fhj.2026.100550
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