Sloper P
Social Policy Research Unit, University of York, Heslington, York, UK.
Child Care Health Dev. 2004 Nov;30(6):571-80. doi: 10.1111/j.1365-2214.2004.00468.x.
Greater collaboration between agencies and the need to improve interagency working is a key policy priority. The lack of co-ordinated multi-agency working in children's services has been highlighted in many research studies. Evidence on the facilitators of and barriers to such working and the outcomes for children and families of co-ordinated services is important to inform local developments.
Literature on multi-agency working was reviewed as part of the evidence gathering to inform the Children's National Service Framework. Searches were mainly concentrated on existing reviews, plus recent studies which included children's services and were not covered by the reviews obtained.
There is little evidence on the effectiveness of multi-agency working itself or of different models of such working in producing improved outcomes for children and families. However, reviews of evidence on multi-agency working provide consistent findings on facilitators and barriers, including: clear aims, roles and responsibilities and timetables that are agreed between partners; a multi-agency steering group, commitment at all levels of the organizations involved and good systems of communication and information sharing, including IT systems, are central; support and training for staff in new ways of working is needed. There is some evidence that interprofessional programmes of continuing education can help to remove barriers to joint working.
Existing research provides useful information for organizations developing multi-agency services. However, there is a need for methodologically sound research which investigates the outcomes of different models of multi-agency working in services for children, includes assessment of cost effectiveness, and explores the ways in which the factors identified as facilitating multi-agency working relate to outcomes.
各机构之间加强合作以及改善跨部门协作是一项关键的政策重点。许多研究都强调了儿童服务领域缺乏协调一致的多机构合作。了解此类合作的促进因素、障碍以及协调服务对儿童和家庭的影响,对于地方发展具有重要意义。
作为为儿童国家服务框架收集证据的一部分,对有关多机构合作的文献进行了综述。搜索主要集中在现有综述上,另外还包括近期未被所获综述涵盖但涉及儿童服务的研究。
几乎没有证据表明多机构合作本身或不同合作模式能为儿童和家庭带来更好的结果。然而,对多机构合作证据的综述在促进因素和障碍方面得出了一致的结论,包括:合作伙伴之间明确的目标、角色、责任和时间表;一个多机构指导小组、相关组织各级的承诺以及良好的沟通和信息共享系统(包括信息技术系统)至关重要;需要为工作人员提供新工作方式的支持和培训。有一些证据表明跨专业继续教育项目有助于消除联合工作的障碍。
现有研究为开展多机构服务的组织提供了有用信息。然而,需要进行方法严谨的研究,调查儿童服务中不同多机构合作模式的结果,包括成本效益评估,并探索所确定的促进多机构合作的因素与结果之间的关系。