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Book part
Publication date: 11 August 2014

Jenna M. Evans, Ross G. Baker, Whitney Berta and Barnsley Jan

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international…

Abstract

Purpose

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

Methods

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Findings

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

Originality/value

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

Keywords

Article
Publication date: 1 October 2004

Guus Schrijvers and Erika Manten

This article introduces the on‐line International Journal of Integrated Care to British subscribers to the Journal of Integrated Care. It is hoped that a working partnership can…

Abstract

This article introduces the on‐line International Journal of Integrated Care to British subscribers to the Journal of Integrated Care. It is hoped that a working partnership can be established between the two publications.

Details

Journal of Integrated Care, vol. 12 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Book part
Publication date: 4 December 2016

Dag Olaf Torjesen, Gro Kvåle and Charlotte Kiland

Integration between primary and secondary healthcare services and institutions has been at the core of health policy in Scandinavian countries over the last decade. This paper is…

Abstract

Integration between primary and secondary healthcare services and institutions has been at the core of health policy in Scandinavian countries over the last decade. This paper is based on an explorative case study of recent reforms in the healthcare sector and their outcomes in Denmark, Norway and Sweden. We discuss the possibilities of and problems for integrating the healthcare sector through the coordination mechanisms of hierarchy, market and network. The paper also discusses whether the institutional logic of the healthcare field is moving from a dual logic of ‘cure’ and ‘care’ towards a unifying logic of ‘integrated care’. We find that although the organisational principles that regulate the relationship between actors in the healthcare field in the three countries have changed, the challenge of achieving a mix of coordinative mechanisms that promote, rather than weaken, integration remains. However, the new organisational and regulative arrangements are an arena for increased interaction and collaboration between the actors, and thus a foundation for change towards the institutional logic of integrated health care.

Details

Towards a Comparative Institutionalism: Forms, Dynamics and Logics Across the Organizational Fields of Health Care and Higher Education
Type: Book
ISBN: 978-1-78560-274-0

Keywords

Book part
Publication date: 26 September 2022

Trynke Keuning, Rachel Verheijen-Tiemstra, Wenckje Jongstra and René Peeters

In the Netherlands, childcare and primary schools are governed by two different systems of two ministries, and although these institutes are usually located nearby, there always…

Abstract

In the Netherlands, childcare and primary schools are governed by two different systems of two ministries, and although these institutes are usually located nearby, there always have been low levels of cohesion with respect to institute-to-institute collaboration. However currently, there is a national trend in enhancing interprofessional collaboration (IPC) with the aim of inclusion and equity. This study focuses on getting insight into the differences in intensity of collaboration and how IPC is organized. A two-dimensional Child Centre Integration Model which accounts for the variations in the degree of IPC in child centres and gives insight into IPC at different levels and into conditions for intensifying IPC is presented. That Dutch education and childcare systems do not connect with each other is seen to be an important cause of the failure or complication of IPC. Because the systems do not connect at the macro level, we see struggles in the necessary normative dimension due to status differences (i.e., inequality between employees) and differences in funding and autonomy. Differences between public (education) and private (childcare) institutions also lead to difficulties when it comes to fostering closer collaboration. This chapter ends with key lessons for practice and policy, including the suggestion that one strong ministry for child affairs, including education and childcare, which stimulates an unambitious course at national level, is required. This course can then be translated at regional and local levels.

Details

School-to-School Collaboration: Learning Across International Contexts
Type: Book
ISBN: 978-1-80043-669-5

Keywords

Article
Publication date: 28 August 2007

Saskia Franken, Bas Savenije and Jennifer Smith

The purpose of this paper is to outline the development of the institutional repository of Utrecht University, the Igitur Archive. The Utrecht repository is unique for several…

Abstract

Purpose

The purpose of this paper is to outline the development of the institutional repository of Utrecht University, the Igitur Archive. The Utrecht repository is unique for several reasons: it was started several years before the international repository movement began; the repository is combined with an e‐publishing service, Igitur, Utrecht Publishing and Archiving Services; and because the repository is firmly embedded in the structural tasks of the university library. This case‐study highlights the advantages and disadvantages of this particular situation.

Design/methodology/approach

In order to give an outline of the evolution of the Igitur Archive, the paper uses information from policy papers and annual reports of the Utrecht University Library and Utrecht University, from the business plan of Igitur and from the Proceedings of the Dutch DARE project. The findings are sorted in four sections: the start of e‐publishing in Utrecht; a section about Igitur; a section detailing the lessons learned; and finally a glance at the future is given.

Findings

The conclusion is that the position of Utrecht as an “early adapter” in the Dutch repository movement has caused some delays, but that the combination of the repository with the additional e‐publishing services has proved to be very fruitful. Igitur has developed a strong position and both the e‐publishing services and the repository have a sound base for further growth.

Originality/value

This paper gives useful information to other university libraries who want to start a repository and an e‐publishing service or who are already developing such services.

Details

OCLC Systems & Services: International digital library perspectives, vol. 23 no. 3
Type: Research Article
ISSN: 1065-075X

Keywords

Abstract

Details

Integrated Care: Reflections on Change in Health Services
Type: Book
ISBN: 978-1-80117-978-2

Book part
Publication date: 18 November 2022

Rory Shand, Steven Parker and Catherine Elliott

Public service ethos (PSE) is traditionally associated with public administration, bureaucracy and frontline response. Thinkers such as Aristotle and Weber embedded ideas of…

Abstract

Public service ethos (PSE) is traditionally associated with public administration, bureaucracy and frontline response. Thinkers such as Aristotle and Weber embedded ideas of public virtue and vocation, yet new managerialism, as well as changes to public services management challenge traditional notions of PSE. Recent events such as the COVID-19 pandemic, counter terrorism and government austerity agendas have put PSE back into the public eye. In this chapter we examine the context for a renewed PSE as a crucial aspect of resilience for workers in public services and public management. We focus on three areas that we feel are important for PSE: policy, purpose and pedagogy, and how a renewed PSE can inform pedagogy in the discipline, renewing ideas of vocation in public administration training.

Details

Reimagining Public Sector Management
Type: Book
ISBN: 978-1-80262-022-1

Keywords

Book part
Publication date: 12 December 2022

Genevra F. Murray and Valerie A. Lewis

While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to…

Abstract

While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.

Details

Responding to the Grand Challenges in Health Care via Organizational Innovation
Type: Book
ISBN: 978-1-80382-320-1

Keywords

Article
Publication date: 13 February 2024

Lisa Knight, Rafaela Neiva Ganga and Matthew Tucker

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of…

Abstract

Purpose

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Design/methodology/approach

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

Findings

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Research limitations/implications

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

Originality/value

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

Keywords

1 – 10 of 193