Fleury Marie-Josée
Department of Psychiatry, McGill University, Douglas Hospital Research Center, 6875 LaSalle Blvd., Verdun (Québec), Canada H4H 1R3.
Int J Integr Care. 2005;5:e07. doi: 10.5334/ijic.127. Epub 2005 Jun 1.
In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks.
The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada) with the author as principal investigator.
Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented.
To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.
在医疗保健系统转型过程中,引入综合服务网络被视为提高效率的主要解决方案之一。在过去几年里,涌现出了大量关于服务整合主题的文献。然而,关于如何构建综合服务网络以适应不同实施环境的问题几乎未被涉及。为填补这一空白,本文提出了四种心理健康综合网络的组织模式。
所提出的模式源自作者作为主要研究者近期发表的三项关于加拿大魁北克省心理健康综合服务的研究。
在解释了综合服务网络的概念并描述了魁北克心理健康网络的背景之后,介绍了适用于所有环境(农村、城市或半城市以及大都市)的模式,并在四张图中进行了总结。
为成功应用这些模式,强调了根据所涉及的整合类型(功能/行政、临床和医生系统),在战略、战术和运营层面召集系统所有参与者的必要性。还强调了在网络中的组织和参与者之间规范活动以及加强地方层面治理机制的重要性。最后,提出了一些整合策略以及使综合服务网络运作成功的关键条件。