Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Lin, Blossom Yen-Ju

doi:10.1186/1472-6963-7-90

Cited by 8 publications

(11 citation statements)

References 34 publications

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“…This study advances the literature on clinical integration and coordination in primary care [ 6 , 11 , 29 – 33 ]. Coordination is an important dimension of primary care practice [ 34 ].…”

Section: Discussionmentioning

confidence: 54%

How personal and standardized coordination impact implementation of integrated care

Benzer

Cramer

Burgess

et al. 2015

BMC Health Serv Res

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BackgroundIntegrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care.MethodsSemi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations.ResultsInterviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures.DiscussionThis study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation.ConclusionIntegrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.

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“…This study advances the literature on clinical integration and coordination in primary care [ 6 , 11 , 29 – 33 ]. Coordination is an important dimension of primary care practice [ 34 ].…”

Section: Discussionmentioning

confidence: 54%

How personal and standardized coordination impact implementation of integrated care

Benzer

Cramer

Burgess

et al. 2015

BMC Health Serv Res

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“…As a pretest, a pilot study was conducted among the PCCN pioneers (92 member clinics) and 116 hospital providers that had partner relationships with other health care organizations (hospitals, clinics, and long-term care facilities; Lin, 2007). The questionnaire was reviewed by two academic experts for accuracy.…”

Section: Survey Instruments: Measurement Of Study Variablesmentioning

confidence: 99%

“…Coordination has the ability to connect and upgrade the information systems to combine clinical, financial, and utilization data (Lin, 2007). Information coordination infrastructure means coordinating information flow among the individual units and efficiently managing the continuum.…”

Section: Survey Instruments: Measurement Of Study Variablesmentioning

confidence: 99%

Partnership effectiveness in primary community care networks

Lin

2010

Health Care Management Review

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Using the individual PCCN as the unit of analysis, the results found that a network's efforts regarding coordination infrastructures were positively related to the PCCN's perceived performance and willingness to remain within the network. In addition, PCCNs practicing in rural areas and in areas with higher density of medical resources had better perceived effectiveness and willingness to cooperate in the network.Practical Implication: The lack of both an operational definition and an information about system-wide integration may have obstructed understanding of integrated health networks' organizational dynamics. This study empirically examined individual PCCNs and offers new insights on how to improve networks' organizational design and effectiveness.

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“…Furthermore, Rummery [7] cautions about the lack of evidence with respect to the success of health care networks. A number of studies have already contributed to closing the gap in research on how health care networks should be structured and managed; such as Lin [8], van Raak et al [9], D’Amour et al [10], and McInnes et al [11]. While these are important contributions that also emphasize the relevance of organizational aspects in the success of health care networks, they do not focus on the governance part.…”

Section: Introductionmentioning

confidence: 99%

Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

Willem

Gemmel

2013

BMC Health Serv Res

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BackgroundHealth care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness.MethodsThe study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for.ResultsNeither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors.ConclusionsAlthough the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.

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Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Cited by 8 publications

References 34 publications

How personal and standardized coordination impact implementation of integrated care

How personal and standardized coordination impact implementation of integrated care

Partnership effectiveness in primary community care networks

Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

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