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1 – 10 of over 8000This chapter investigates the origins of cross-sectoral collaboration by exploring when and why policy networks form within the Turkish health sector – a least likely case…
Abstract
This chapter investigates the origins of cross-sectoral collaboration by exploring when and why policy networks form within the Turkish health sector – a least likely case for network formation. The analysis presented here draws on information collected from a number of official documents, semi-structured interviews with professional experts, and two multi-stakeholder meetings. Timewise, networks entered the policy jargon during the introduction of the Health Transformation Program in 2003. Yet, the years between 2011 and 2015 were ground-breaking in producing concrete cross-sectoral collaborative instruments of policy making. The findings of the analysis reveal that policy networks form as a result of central government’s choice to devolve responsibility and expand the policy space with new issues and actors. Moreover, policy networks emerge not only during the times of policy change which has a reactionary, abrupt, and nature but also during the times of policy stability and legitimacy. These contextual factors are crucial in maintaining an atmosphere of trust among stakeholders, particularly between state and non-state actors. The refugee crisis and spreading securitization discourse in the post-2015 period explain the shifting policy and political agenda leading to public sector retrenchment from cross-sectoral projects within the field of health. This chapter intends to contribute to the literature of comparative public policy by examining the link between policy networks and policy change in addition to adding to the debates on network governance by exploring the processes of network formation. Finally, this chapter contributes to Turkish studies by examining the process of network formation within the Turkish health sector.
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Bill Doolin and Andrew W. Hamer
This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these…
Abstract
Purpose
This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these multi-stakeholder, clinician-led modes of organizing. It describes the development of a national clinical network to achieve system-wide improvement in the provision of publicly funded cardiac surgery services in New Zealand, and the subsequent evolution of a broader network encompassing the whole cardiac care patient pathway.
Design
The case study of the two cardiac clinical networks focuses on the emergence and evolution of the networks over a four-year period from 2009. Data were collected from interviews with key stakeholders of both networks and from internal and published documentary evidence. Analysis of the case study is informed by network theory and prior studies of managed clinical networks.
Findings
Progress made towards the achievement of the goals of the initial cardiac surgery network encouraged a broadening of focus to the entire cardiac care pathway and the establishment of the national cardiac network. An important benefit has been the learning and increase in understanding among the different stakeholders involved. Both clinical networks have demonstrated the value of clinician engagement and leadership in improving the delivery of health services, and serve as a best practice model for the development of further clinical networks for health services that require a national population base.
Originality and value
The case study analysis of the two cardiac clinical networks identifies five mutually reinforcing themes that underpin network effectiveness: network structure, management and governance, and internal and external legitimation. These themes encompass a number of factors suggestive of successful managed clinical networks, and offer insights into the use of such networks in organizing for sustainable healthcare.
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Marco Meneguzzo, Valentina Mele and Angelo Tanese
This study focuses on a particular type of public organization characterized by weak boundaries and strong informal relationships, elements that have assisted in driving…
Abstract
This study focuses on a particular type of public organization characterized by weak boundaries and strong informal relationships, elements that have assisted in driving the reform of an entire national public management system. The case is the Public Healthcare System of the Southern Italy in the period beginning in the early 1990s through the beginning of the new millennium, with particular emphasis on the Sicilian region, selected since it represents an extreme case of informal networks that affect organizational boundaries and governance functions.
Mary L. Fennell and Ann Barry Flood
The Stanford School of Organizational Sociology has influenced the development and direction of healthcare organizations as a field of research in several very significant…
Abstract
The Stanford School of Organizational Sociology has influenced the development and direction of healthcare organizations as a field of research in several very significant ways. This chapter will provide a focused review of the major paradigms to develop from work at Stanford from 1970 to 2000, much of which involved the study of processes and structures within and surrounding healthcare organizations during this period. As a subarea of organizational theory and health services research, healthcare organizations embrace both theory-based research and applied research, and they borrow concepts, theories, and methods from medical sociology, organizational theory, healthcare administration and management, and (to a more limited extent) health economics and decision theory. The bulk of this chapter will focus on four major themes or paradigms from research on healthcare organizations that grew from work by faculty and students within the Stanford School of Organizational Sociology: Health Care Outcomes, Internal Organizational Dynamics, Organizations and Their Environments, and Organizational Systems of Care and Populations of Care Providers. Following our examination of these four paradigms, we will consider their implications for current and future debates in health services research and healthcare policy.
The purpose of this paper is to analyse the management of commercial actors in strategic networks of emergency preparedness management (EPM) in developed countries and how…
Abstract
Purpose
The purpose of this paper is to analyse the management of commercial actors in strategic networks of emergency preparedness management (EPM) in developed countries and how these strategies connect to the emergency response efficiency. This study uses collaboration, strategy, and efficiency to evaluate the private governance of the food, healthcare, and transportation sectors and follows an analysis of these sectors’ management that finds an ambivalent impact on the efficiency of the worldwide supply chain network (SCN) system. This study discusses many strategic networks and nets of commercial standards with different management structures and emphasizes illustrating the EPM context, thereby offering directions for future research.
Design/methodology/approach
An empirical research approach and triangulation methodology was adopted to design the selection, evaluation, and contribution of the observed data and the humanitarian and business literature. An overview of strategic networks’ role in EPM in Sweden comprises several network approaches and considers the strategic value of three SCNs for response efficiency.
Findings
The study finds that strategic networks are relevant for EPM and response efficiency and can be delimited and adapted to developing countries’ demands. However, growing interest in networks’ strategic value for EPM stresses public-private collaboration as a strategic choice to achieve response efficiency. To offer strategic planning that ties demand with supply, public-private actors must collaborate in SCNs.
Originality/value
The study contributes to the existing literature on strategic networks, for example, industrial networks, by illustrating their strategic value for developed countries’ SCNs. It also contributes to the business literature, for example, on strategic net management. The work is original because it adopts a practical perspective involving buyers and suppliers in planning, the delimitation of their capability in nets, and the strategic value of SCN collaboration.
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Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent…
Abstract
Purpose
Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.
Design/methodology/approach
Responding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.
Findings
In total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.
Practical implications
Taken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.
Originality/value
This paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.
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Abdelhakim Altabaibeh, Kay Ann Caldwell and Margaret A Volante
The study presents the findings from a study over a four-year period of the emergence of an integrated healthcare organisation in response to policy changes within the…
Abstract
Purpose
The study presents the findings from a study over a four-year period of the emergence of an integrated healthcare organisation in response to policy changes within the United Kingdom (UK). The aim of the research was to understand the process of healthcare organisation integration through the lens of actor–network theory (ANT).
Design/methodology/approach
An instrumental case study approach to data collection was selected. Three methods of data collection were used to trace the healthcare organisation integration process: in depth semistructured interviews using a virtual patient journey across services with 36 purposefully selected informants, document analysis and field observations and notes.
Findings
The findings of this study suggest that neither the context nor the actors were the sole determinants of the outcome of the integration. Rather it was the dynamic interplay between the actors, their context, the shared agency and the resources available to them as the change emerged shaped the end result.
Research implications
The findings denote that organisations need to attend to frontline workers as key contributors to change and development that is meaningful for service users. Methodologically, combining the ANT and constructive case study to understand the integration process provided us with new perspective to understand the trajectory of change process.
Originality/value
This original case study fills a gap in information about the role of healthcare professionals in healthcare policy process and the interactive relationship between all stakeholders of policy process including nonhuman actors.
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Chiara Paltriccia and Lorenzo Tiacci
The purpose of this paper is to present a new outsourcing model for materials management related to the operating theatre of hospitals. Two distinguishing features…
Abstract
Purpose
The purpose of this paper is to present a new outsourcing model for materials management related to the operating theatre of hospitals. Two distinguishing features characterize the model: the long-term collaborative network established among the supplying companies (the “Network factor”), and the implementation of the RFID technology along the supply chain (the “RFID factor”). The network factor allows sharing transportation costs, while the RFID factor allows implementing a continuous review policy, instead of the periodic review policy normally utilized in hospitals. In the paper the effect of these two factors on the minimization of total materials management costs is investigated.
Design/methodology/approach
An analytical model, validated through a simulation study, is proposed to calculate total management costs of materials, depending on the presence of the network and the RFID factors. Throughout the model it is possible to perform a scenario analysis and individuate the inventory management policy that allows minimizing total costs. The procedure has been applied to a real case study of a long-term collaborative network of supplying companies in the healthcare sector that operates in Central Italy.
Findings
The optimal inventory management policy strongly depends on the mutual distances of supplying companies and the hospital. Both of the two factors have an impact on the reduction of total annual costs. The analysis of the scenario shows that a positive interaction effect exists between the two factors, so that higher savings are obtained when both factors are present.
Originality/value
The outsourcing model presented in the paper is new, and the managerial insights that can be drawn from the application of the model to the healthcare sector can be extended to many other industries.
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Kai Härkönen, Pauliina Ulkuniemi and Jaana Tähtinen
The purpose of this paper is to describe the competences needed for managing competitive bidding in the Finnish healthcare and to understand the management of competitive…
Abstract
Purpose
The purpose of this paper is to describe the competences needed for managing competitive bidding in the Finnish healthcare and to understand the management of competitive bidding holistically, considering the challenges the management faces from being embedded in focal nets and the wider network.
Design/methodology/approach
The phenomenon is examined from the perspective of networks. This focus acknowledges the fact that competitive bidding changes the dynamics of the network and therefore requires new competences from the actors. The study applies qualitative methods.
Findings
Competitive bidding connects effects, interests, resources and actors together. It changes the dynamics of the net and the network. Thus, new competences are required. Three major competence areas were detected: relationship management competences, net management competences and purchasing competences.
Originality/value
The conclusions shed light on the combination of competences needed in managing competitive bidding in healthcare networks.
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