Nordic School of Public Health, P.O. Box 12133, SE-402 42 Göteborg, Sweden and Stockholm Centre for Public Health, P.O. Box 17533, SE-118 91 Stockholm, Sweden.
Int J Integr Care. 2008 Jun 19;8:e52. doi: 10.5334/ijic.234.
A project of vocational rehabilitation was studied in Sweden between 1999 and 2002. The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service. The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration.
Theories of inter-professional and inter-organisational integration, and theories on organisational change.
In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002. A thematic approach was used for the analysis of the data.
THREE DIFFERENT MAIN THEMES OF BARRIERS EMERGED FROM THE DATA: A Uncertainty, B Prioritising own organisation and C Lack of communication. The themes are interconnected in an intricate web and hence not mutually exclusive.
The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration. Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project. This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication. A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration.
1999 年至 2002 年期间，瑞典开展了一项职业康复项目。该项目涉及四个公共组织：社会保险局、地方卫生服务机构、市社会服务处和国家就业服务办公室。本文旨在分析跨组织整合发展中感知到的障碍。
跨专业和跨组织整合理论，以及组织变革理论。
1999 年至 2002 年期间，对项目内的参与者进行了 51 次半结构化访谈和 14 次焦点小组讨论。采用主题方法对数据进行分析。
从数据中得出了三个不同的主要障碍主题：A. 不确定性，B. 优先考虑自己的组织，C. 缺乏沟通。这些主题相互交织，因此并非相互排斥。
发现的障碍都与一般的组织变革有关，部分与组织整合的具体发展有关。优先考虑自己的组织导致沟通不畅，进而导致项目中存在高度的不确定性。这可以看作是一个循环关系，因为不确定性可能会增加对自己组织的关注和缺乏沟通。克服这些障碍的一种方法是将客户的需求作为联合服务发展的出发点，并让他们也参与到跨组织整合的发展中来。
