Understanding Multilevel Governance Processes through Complexity Theory: An Empirical Case Study of the Quebec Health-Care System

Touati, Nassera; Maillet, Lara; Paquette, Marie-Andrée; Denis, Jean‐Louis; Rodríguez, Charo

doi:10.1080/01900692.2017.1423501

Cited by 15 publications

(18 citation statements)

References 24 publications

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“…The historical imbalances in funding and power between physician-focused organizations such as hospitals and nursing/rehabilitation-focused organizations such as home health care is a widely acknowledged tension in many health systems. How this and other tensions can be better understood, agreed upon, and overcome by individuals and organizations intending to work more closely together to provide better care has been an under-represented challenge in the literature on integrated care [13]. In our paper, we focus specifically on identifying potential strategies to enable better interorganizational collaboration through collaborative governance mechanisms, particularly under circumstances of evolving policy environments.…”

Section: The Collaborative Processmentioning

confidence: 99%

Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue

Gordon

McKay

Marchildon

et al. 2020

International Journal of Integrated Care

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The goal of achieving integrated care increasingly characterizes the efforts of health systems around the world to improve effectiveness, efficiency and outcomes, yet the implementation of integrated care remains an extremely complex challenge. Although large multinational projects have provided early understandings into the optimal ways to implement more integrated models of care [1, 2], insights into strategies to navigate the political and managerial demands of implementing change are

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Section: The Collaborative Processmentioning

confidence: 99%

Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue

Gordon

McKay

Marchildon

et al. 2020

International Journal of Integrated Care

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“…A CAS, is capable of modification and learning from its previous experiences (Touati et al., 2019). It reacts to the local environment and local knowledge within which it operates (Chaffee and McNeill, 2007).…”

Section: What Is Ct?mentioning

confidence: 99%

Missed nursing care and complexity theory: a conceptual paper

Albsoul

FitzGerald

Hughes

et al. 2021

Journal of Research in Nursing

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Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

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“…An alternative form is the type II multilevel governance where the jurisdictions often overlap and operate at huge territorial scales depending on the nature of the policy problem addressed, for example, monitoring water quality of a particular river, resolve conflicts pertaining to common pool resources etc. 49 Divay and Paquin (2013, cited by Touati 51 ) argued that multilevel governance is not merely restricted to intergovernmental relations rather it involves flexibility in role sharing between various stakeholders (both state and non-state) at multiple levels in the governance processes. For our systematic scoping review we consider the conceptualisation of multilevel governance as the one that is characterised by ‘the study of the crossroads of the vertical (intergovernmental) and horizontal (state-society) dimensions’.…”

Section: Rationalementioning

confidence: 99%

Towards a multilevel governance framework on the implementation of patient rights in health facilities: a protocol for a systematic scoping review

et al. 2020

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IntroductionPatient rights are “those rights that are attributed to a person seeking healthcare”. Patient rights have implications for quality of healthcare and acts as a key accountability tool. It can galvanise structural improvements in the health system and reinforces ethical healthcare. States are duty bound to respect, protect and promote patient rights. The rhetoric on patient rights is burgeoning across the globe. With changing modes of governance arrangements, a number of state and non-state actors and institutions at various levels play a role in the design and implementation of (patient rights) policies. However, there is limited understanding on the multilevel institutional mechanisms for patient rights implementation in health facilities. We attempt to fill this gap by analysing the available scholarship on patient rights through a critical interpretive synthesis approach in a systematic scoping review.MethodsThe review question is ‘how do the multilevel actors, institutional structures, processes interact and influence the patient rights implementation in healthcare facilities? How do they work at what level and in which contexts?” Three databases PubMed, LexisNexis and Web of Science will be systematically searched until 30th April 2020, for empirical and non-empirical literature in English from both lower middle-income countries and high-income countries. Targeted search will be performed in grey literature and through citation and reference tracking of key records. Using the critical interpretive synthesis approach, a multilevel governance framework on the implementation of patient rights in health facilities which is grounded in the data will be developed.Ethics and disseminationThe review uses published literature hence ethics approval is not required. The findings of the review will be published in a peer-reviewed journal.Registration numberPROSPERO 2020 CRD42020176939

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Understanding Multilevel Governance Processes through Complexity Theory: An Empirical Case Study of the Quebec Health-Care System

Cited by 15 publications

References 24 publications

Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue

Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue

Missed nursing care and complexity theory: a conceptual paper

Towards a multilevel governance framework on the implementation of patient rights in health facilities: a protocol for a systematic scoping review

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