Intersectoral collaboration at a decentralized level: information flows in child welfare and healthcare networks

Abstract

Background As needs of families with social and behavioral health problems often exceed the expertise and possibilities of a single professional, service or organization, cross-service collaboration is indispensable to adequately meeting those needs. Despite the progressive focus on organizing integrated care, service fragmentation and service duplication remain persistent problems in child welfare and healthcare service delivery systems. A crucial factor to overcome these problems is information exchange between organizations. This study explores and compares the development over time of structures of information exchange in networks, concerning both material and knowledge-based information. Methods A comparative case study and social network analysis of three inter-organizational networks of child welfare and healthcare services in different-sized municipalities in the Netherlands. The research population consisted of organizations from various sectors participating in the networks. Data were collected at two moments in time with a mixed method: semi-structured interviews with network managers and an online questionnaire for all network members. Density and degree centralization were used to examine the information exchange structures. Ucinet was used to analyze the data, with use of the statistical tests: Compare Density Procedure and Quadratic Assignment Procedure. Results This study shows that different structures of information exchange can be distinguished, concerning both material and knowledge-based information. The overall connectedness of the studied structures of the networks are quite similar, but the way in which the involvement is structured turns out to be different between the networks. Over time, the overall connectedness of those structures appears to be stable, but the internal dynamics reveals a major change in relationships between organizations in the networks. Conclusions Our study yields empirical evidence for the existence of and the differences between structures and dynamics of both material and knowledge-based information exchange relationships. With a loss of more than a half of the relations in a year, the relationships between the organizations in the network are not very stable over time. The contrast between major internal dynamics and the stable overall connectedness is an important point of concern for network managers and public officials, since this impermanence of relations means that long-term integrated care cannot be guaranteed.

Actors’ awareness of network governance in Child Welfare and Healthcare service networks

“…Also, an important facilitator for cross-service collaboration is the presence of information exchange relationships within a child service network [6,8,71]. As information exchange is vital for a shared understanding of families' needs, a timely response and inter-professional collaboration, network managers should consider strategies to build and preserve internal stable relationships [43,72]. An important point of concern for network managers is that they cannot effectively play the lead role when the purported lead organization is not identified as such by the network members.…”

“…Here it is also important that the type of relationship, i.e., horizontal or vertical, with the lead organization is considered. It has been shown that the structure of the network depends on the tangibility of resources being exchanged [72][73][74][75][76]. This could mean that organizations in the network that primarily exchange tangible resources with the lead organization, such as financial capital through contracts and invoices, function better with a vertical, buyer-supplier relationship with the lead organization.…”

Intersectoral Collaboration to Promote Child Development: The Contributions of the Actor-Network Theory

“…Relationships among people and organizations are expressions of power (im)balances, which is a fundamental factor that requires continued research to provide a better understanding of how to achieve shared goals ( Glandon et al, 2019 ; Such et al, 2022 ). A deeper understanding of the diversity of arrangements for the various public services involved in intersectoral actions and the different levels of involvement and integration among the services, policymakers, and practitioners is required ( Blanken et al, 2022 ; Neves et al, 2021 ; Okeyo et al, 2020 ). The mapping of the intersectoral networks within various contexts can contribute to understanding the relationships and ways this network works, identifying patterns of interaction (both formal and informal) to refine the knowledge of types of intersectoral arrangements.…”

L’obligation de signalement aux services de protection de l’enfance : analyse situationnelle de sa mise en oeuvre dans les pratiques de soins primaires

“…Au Québec (Canada), les récents débats publics relatifs à la maltraitance envers les enfants ont mis en exergue les problématiques internes aux services de protection de l'enfance (ci-après, SPE) et le manque de continuité entre ces services et les services offerts en communauté. Cette problématique est également documentée à l'international (Nouman et al, 2020;Tung et al, 2019;Blanken et al, 2022). Le quotidien de la pratique du personnel infirmier agissant en prévention de la maltraitance reste paradoxalement méconnu et peu documenté.…”