Improving Quality of Care Through Integration in a Hospital Setting: A Human Systems Integration Approach

Abstract

While many studies suggest that integration is positively associated with improved quality of care, others assert that this may not be so. The inconsistent success of integration to improve performance is not limited to healthcare operations, but is prevalent in operations and engineering management in general. We suggest that this inconsistency exists because many integration studies examine technical components of integration, but not human components of integration. We use recent works on the theory of Human Systems Integration (HSI) to explain how the technical components of a system, examined through formal integrative practices and informal integrative practices, and the human components of a system, examined through belief in integration and understanding of integration, interact to influence quality of care. In a study of 34 hospital departments, we found strong support for the interaction between the technical and human components, such that formal integrative practices are associated with higher quality of care when understanding of integration is high rather than low as we theoretically suggest. Unexpectedly, our results also suggest that not all integration practices influence quality of care; we discuss the implications of these findings for practice and future research applications. High understanding of integration Low understanding of integration

Impact of High-Performance Work Practices on Efficiency and Effectiveness of Multispecialty Healthcare Service Delivery in an Emerging Economy—Role of Relational Coordination

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“…The model also depicts directions of integration, that is, vertical and horizontal , referring to integration taking place between different and within similar levels of care. Additionally, functional and normative dimensions capture both the technical and social-ecological aspects of integrating care, which has been respectively referred to as technical and human components in other literature (Glover et al , 2017). The Rainbow Model contains 59 key features of integrated care, with the six larger dimensions of the system, organizational, professional, clinical, functional and normative Valentijn et al (2015).…”

“…While several existing frameworks point to contextual factors that may facilitate the development and implementation of integrated care, scholars continue pointing out the lack of attention to “human” elements, which may be key to understanding the success or failure of integration efforts (Glover et al , 2017; Singer et al , 2020). Others have recognized the absence of intangible elements such as the socio-ecological climate in prior models of integrated care (Singer et al , 2020) and characteristics of the people involved in implementing and delivering integrated care (Glover et al , 2017). Additionally, macro factors such as the public policy, funding environment, market conditions and interorganizational infrastructure as well as organizational leadership have been emphasized to be considered in integration efforts (Singer et al , 2020; Valentijn et al , 2013, 2015).…”

“…While several existing frameworks point to contextual factors that may facilitate the development and implementation of integrated care, scholars continue pointing out the lack of attention to "human" elements, which may be key to understanding the success or failure of integration efforts (Glover et al, 2017;Singer et al, 2020). Others have recognized the absence of intangible elements such as the socio-ecological climate in prior models of integrated care (Singer et al, 2020) and characteristics of the people involved in implementing and delivering integrated care (Glover et al, 2017).…”