How to manage the implementation of shared care ‐ A discussion of the role of power, culture and structure in the development of shared care arrangements

Abstract

The Dutch health care sector has become familiar with innovation of care delivery in order to meet the changing demand of the steadily ageing population, in need of complex care. Innovations often concern the implementation of shared care models, implying collaboration and substitution of care. Whereas ageing is a European-wide phenomenon, the development of such new care arrangements can be observed not only in The Netherlands, but also in the UK, Scandinavia, Italy and other countries. In this article we discuss the implementation of shared care, with the help of three concepts: power, culture and structure. We discuss the role of these factors from the view that shared care can be considered as inter-professional working within a network context. The central question is how structure, culture and power can offer change managers a starting-point for improving their innovative capacity. To illuminate our discussion we make use of a number of event-descriptions from five Dutch shared care projects. Also, we give some practical recommendations for change managers.

Comparing integrated care policy in Europe: Does policy matter?

“…As a result, professionals often act in ways that defend or enhance their own interests. These include deliberate bargaining, negotiating, and exercising subtle manipulation or overt social control [33]. Clearly, this behaviour does not contribute to the smooth implementation of integrated care.…”

How the professionals can identify needs for improve- ment and improve Food Distribution service for the home-living elderly people in Sweden - an action research project

“…the personnel involved in the development of home and care practice is beneficial, since these people have unique experiences of the issue in a local context and can focus on the practical problems they face in their daily work and practice [14] . Other benefits offered by the involvement of the different personnel is that it promotes collaboration across professional boundaries, which has been shown to be beneficial for care receivers and care and service organisation personnel [15] . The most optimal scenario in a practice development process is one where motivated personnel initiate improvements and are active during the AR process [16,17] .…”

Networks for integrated care provision: an economic approach based on opportunism and trust

“…More recently, we see cooperation efforts not directed to mergers, while dissimilar organizations are involved. For detailed studies of integrated care in The Netherlands, the reader is referred to the work of Linden et al [6], Mur-Veeman and co-workers [7][8][9], Hardy et al [1], and Kumpers et al [3], A common observation is the recognition of interdependence and willingness to pursue integration of service for multi-problem patients. In the latter two articles [1,3], the English and the Dutch situation are compared.…”

“…Starting from the departure point of 'common-sense knowledge' of the health sector and given that health networks are observable in the real world [1][2][3][6][7][8][9], the goal of this paper is to analyse integrated care from an economic organization (EO) theory perspective. In this respect, our paper differs from approaches to integrated care where analysis of governmental policies, development of recommendations to policy makers, etc.…”