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促进多部门医疗保健联盟组织参与者内部的变革。

Fostering change within organizational participants of multisectoral health care alliances.

机构信息

Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Health Care Manage Rev. 2012 Jul-Sep;37(3):267-79. doi: 10.1097/HMR.0b013e31822aa443.

Abstract

BACKGROUND

A touted advantage of multisectoral health care alliances is their ability to coordinate diverse constituencies and pursue community health goals in ways that allow them to make greater progress than each constituency could independently. However, participating organizations may have goals that do not entirely overlap or necessarily align with the alliance's goals, which can weaken or undermine an alliance's efforts. Fostering changes within participating organizations in ways that are consistent with the alliance's goals (i.e., alliance-oriented change) may be one mechanism by which alliances can coordinate diverse activities and improve care in their local communities.

PURPOSE

We examined whether alliance-oriented change within participating organizations is associated with alliance decision-making and conflict management style, level of participation, perceptions of alliance participation benefits and costs, and awareness of alliance activities within participating organizations.

METHODOLOGY

The study used two rounds of survey data collected from organizational participants of 14 alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program.

FINDINGS

Alliance participants generally reported low levels of alliance-oriented change within their organizations as a result of the alliance and its activities. However, participants reporting higher levels of internal change in response to alliance activities had more positive perceptions of alliance decision-making style, higher levels of participation in alliance activities, more positive perceptions of alliance participation benefits relative to costs, and greater awareness of alliance activities across multiple levels of their respective organizations.

PRACTICE IMPLICATIONS

Despite relatively low levels of alliance-oriented change within participating organizations, alliances may still have the means to align the goal orientations of a diverse membership and foster change that may extend the reach of the alliance in the community.

摘要

背景

多部门医疗保健联盟的一个优势是,它们能够协调不同的利益相关者,并以一种使他们能够取得比每个利益相关者独立取得更大进展的方式追求社区健康目标。然而,参与组织的目标可能不完全重叠,也不一定与联盟的目标一致,这可能会削弱或破坏联盟的努力。以与联盟目标一致的方式促进参与组织的变革(即联盟导向的变革)可能是联盟协调不同活动和改善其当地社区护理的一种机制。

目的

我们研究了参与组织内部的联盟导向变革是否与联盟的决策和冲突管理风格、参与程度、对联盟参与的收益和成本的看法以及对参与组织内部联盟活动的认识有关。

方法

该研究使用了两轮来自罗伯特伍德约翰逊基金会“Aligning Forces for Quality”计划中 14 个联盟的组织参与者的调查数据。

结果

联盟参与者普遍报告说,由于联盟及其活动,他们的组织内部的联盟导向变革程度较低。然而,报告在回应联盟活动方面有更高水平内部变革的参与者对联盟决策风格有更积极的看法,对联盟活动的参与程度更高,对联盟参与的收益相对于成本的看法更积极,对联盟活动在其各自组织的多个层面的认识也更强。

实践意义

尽管参与组织内部的联盟导向变革程度相对较低,但联盟仍有可能协调多元化成员的目标取向,并促进变革,从而扩大联盟在社区中的影响力。

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