Health service integration: a case study in change management

Abstract

Health service integration seems a logical and desirable strategy to improve both the efficiency and quality of service delivery. Failure of implementation is common but may not be inevitable. This paper reports on a case study involving structured interviews and focus groups within one health service which has attempted to integrate one area of its acute and community health services. Health service integration was regarded very positively by clinicians and administrators in this case study but the change management process utilised in its implementation was not, suggesting a need for

How integrated are homelessness, mental health and drug and alcohol services in Australia?

“…In much the same vein, Allen and Stevens (2007) and Goodwin (2008) suggest that the prime objective of integrated care is to shift the focus of attention from a service delivery to a client-centred approach. In a social housing context, Phillips et al (2009) suggest that the key objectives and potential benefits of the integration of services are improved client outcomes, enhanced client access to services, greater equity and consistency, increased efficiency and enhanced accountability and control.…”

Forming and sustaining partnerships to provide integrated services for young people: an overview based on the headspace Geelong experience

“…Just as it is estimated that approximately 70% of major health change initiatives and business mergers fail to achieve their objectives, there is extensive evidence that failure to either implement or sustain service integration efforts are common. [15][16][17] While there is a considerable healthcare literature on the benefits and challenges of delivering integrated health care, far more practical advice on forming partnerships and sustaining them is found in the management literature. Our journey to create headspace Barwon has involved continuous culture and system change, and we believe our learning from this, the Deakin evaluation and our review of the management and health-care literature have taught us lessons which will be of value to others embarking on interagency collaboration.…”

“…the human, relationship dimensions). 16,17,[22][23][24][25] All of these overlap but deserve individual attention.…”

“…Just as it is estimated that approximately 70% of major health change initiatives and business mergers fail to achieve their objectives, there is extensive evidence that failure to either implement or sustain service integration efforts are common 15–17 . While there is a considerable health‐care literature on the benefits and challenges of delivering integrated health care, far more practical advice on forming partnerships and sustaining them is found in the management literature.…”

“…There is general consensus in the health‐care and management literature that the most common cause of failure in the development of integrated services is lack of attention to managerial imperatives including the need for leadership, a change‐management focus, and attention to organizational culture change and integration (i.e. the human, relationship dimensions) 16,17,22–25 . All of these overlap but deserve individual attention.…”