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从合作到冲突?瑞典康复专业人员的组织间合作体验。

From cooperation to conflict? Swedish rehabilitation professionals' experiences of interorganizational cooperation.

机构信息

Department of Medical and Health Sciences, National Centre for Work and Rehabilitation, Linköping University, 581 83 Linköping, Sweden.

出版信息

J Occup Rehabil. 2011 Sep;21(3):441-8. doi: 10.1007/s10926-010-9281-1.

Abstract

PURPOSE

This article analyses Swedish rehabilitation professionals' experiences of interorganizational cooperation in return-to-work and labour market reintegration.

METHOD

Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis.

RESULTS

Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible sickness insurance regulations and inability of managers to implement cooperation in regular practice.

CONCLUSIONS

While interorganizational cooperation promotes professional discretion and tailored solutions, the insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of sickness insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of sickness insurance regulations needs to be targeted on a system level.

摘要

目的

本文分析了瑞典康复专业人员在重返工作岗位和劳动力市场再融入方面的组织间合作经验。

方法

两组(n=15)来自不同组织的人员定期开会,从合作的角度讨论他们的实践。参与者在协调协会的组织环境中有合作经验。这些小组根据基于问题的方法与导师一起工作,讨论他们的实践如何受到新的合作结构的影响。使用定性内容分析对材料进行了归纳分析。

结果

康复领域的组织间合作通常被认为可以促进一致性和沟通。然而,在实施这种工作形式时存在几个矛盾因素,主要是医疗保险法规的僵化和管理人员无法在常规实践中实施合作。

结论

虽然组织间合作促进了专业的酌处权和量身定制的解决方案,但保险系统通过增加治理来违背这些目标。最终,合作计划的矛盾趋势和医疗保险法规更严格的治理都是政治问题。如果要成功地进行促进组织间合作的政治尝试,就需要针对系统层面来解决医疗保险法规严格治理所导致的日益部门化问题。

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