Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

Grenier, Corinne

doi:10.5334/ijic.526

Cited by 10 publications

(24 citation statements)

References 36 publications

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“…As already stated, this integration is the biggest challenge for the Brazilian system. Grenier (2011) highlights an empirical case study, of a healthcare network in France. This is a thematic network of elderly care, also implemented in 2001.…”

Section: Discussionmentioning

confidence: 99%

Healthcare Networks in Metropolitan Areas - The Case of the Health System in Brazil

Leite¹,

Carneiro²

2015

AJH

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The health care system in Brazil is an example of the complexity and often fragmentation in health policy implementation. The notion of healthcare networks proposes that the health system must be organized through coordinated points to provide continuous and integrated care, based on cooperation between managers, providers, and users. In Brazil in 2010, the Ministry of Health enacted an ordinance defining the healthcare network as a management model to be pursued by the national health policy in order to address most of the difficulties of fragmentation. This paper proposes to discuss the cases of Healthcare Networks in Brazilian metropolitan regions, characterizing its implementation process as well as identifying management problems in various cases. This study is grounded on data provided by agencies responsible for health management in the federal and state levels, as well as the current literature on healthcare networks. Results include the analysis of metropolitan networks implemented within their different stages, challenges and advances.

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Section: Discussionmentioning

confidence: 99%

Healthcare Networks in Metropolitan Areas - The Case of the Health System in Brazil

Leite¹,

Carneiro²

2015

AJH

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“…Trust among organizations is essential for the development and implementation of a joint service charter. Managing the integration necessary for the implementation of the service charter has been shown to be more of a process of deliberation and negotiation between organizations than one of ideology and prescription [ 36 ]. A lack of trust in this process could be a barrier and could block the necessary integration [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

Thomassen

Ahaus

Walle

2014

BMC Health Serv Res

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BackgroundBased on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter.MethodsWe have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process.ResultsWe have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties.ConclusionsThis first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the only integrated care chain using a single service charter that we could find. Nevertheless, the results of our explorative study provide an initial framework for the development and implementation of service charters in integrated care settings. This research contributes to the literature on service charters, on patient-centeredness in integrated care and on the implementation of innovations.

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“…It was important for team leaders to both inspire learning within their teams and to show commitment to learning themselves. There was also a requirement for integrated teams to be willing and flexible to change and evolve according to need [36,37,[46][47][48] but this was more difficult for organisations accustomed to 'silo-working' or where funding models supported care in silos [36,46]. An overarching context for this mechanism was the presence of an organisational culture that demonstrated mutual respect and understanding, which was crucial for nurturing learning and innovation within organisations [36].…”

Section: Mechanism 5 -Commitment To Learning and Development (N = 14) Empirical Evidencementioning

confidence: 99%

What does Success Look Like for Leaders of Integrated Health and Social Care Systems? a Realist Review

Sims

Fletcher

Brearley

et al. 2021

International Journal of Integrated Care

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Introduction: Health and social care services in England are moving towards greater integration, yet little is known about how leadership of integrated care teams and systems can be supported and improved. This realist review explores what works about the leadership of integrated care teams and systems, for whom, in what circumstances and why.Methods: A realist synthesis approach was undertaken in 2020 to explore English language literature on the leadership of integrated care teams and systems, complemented by ongoing stakeholder consultation.Results: Evidence was identified for seven potentially important components of leadership in integrated care teams and systems: 'inspiring intent to work together'; 'creating the conditions'; 'balancing multiple perspectives'; 'working with power'; 'taking a wider view'; 'a commitment to learning and development' and 'clarifying complexity'.Discussion: Research into the leadership of integrated care teams and systems is limited, with ideas often reverting to existing framings of leadership, where teams and organisations are less complex. Research also often focuses on the importance of who the leader is rather than what they do. Conclusion:This review has generated new perspectives on the leadership of integrated care teams and systems that can be built upon, developed, and tested further.

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Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

Cited by 10 publications

References 36 publications

Healthcare Networks in Metropolitan Areas - The Case of the Health System in Brazil

Healthcare Networks in Metropolitan Areas - The Case of the Health System in Brazil

Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

What does Success Look Like for Leaders of Integrated Health and Social Care Systems? a Realist Review

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