Mitterlechner Matthias
University of St Gallen , St Gallen, Switzerland.
J Health Organ Manag. 2018 Oct 8;32(7):860-874. doi: 10.1108/JHOM-01-2018-0012. Epub 2018 Oct 30.
The purpose of this paper is to develop a theory of governing in integrated care networks. Asking how and why the governance of these networks emerges and evolves over time, it responds to calls for more innovative thinking in this field.
DESIGN/METHODOLOGY/APPROACH: Data result from a rare longitudinal qualitative case study conducted with the Healthcare Centre Lower Engadin, the lead organisation of pioneering health and social care network in a rural Swiss region.
Actors governed the network through repetitive sequences of collaborative inquiry, a practice through which they defined and addressed recurrent problems of network governance and joint network action in creative and experimental ways.
RESEARCH LIMITATIONS/IMPLICATIONS: Explaining how and why the governance of integrated care networks emerges and evolves, this study adds a dynamic theory to previous research, which has studied the determinants of effective network governance without considering their temporal evolution. It also contributes to the wider network literature, drawing attention to the pivotal role of meaning making, creativity and experimentation for understanding network governance dynamics.
The study invites practitioners to reflect on how they want to design collaborative inquiry in their own contexts. Important design levers include the creation of communication forums, trust and information transparency.
ORIGINALITY/VALUE: The study adds a rare longitudinal perspective on the governance of integrated care networks.
本文旨在构建综合医疗网络中的治理理论。通过探讨这些网络治理如何以及为何随着时间推移而出现和演变,回应了该领域对更具创新性思维的呼吁。
设计/方法/途径:数据来源于对瑞士一个乡村地区开创性健康与社会护理网络的牵头组织——下恩加丁医疗中心进行的一项罕见的纵向定性案例研究。
参与者通过重复的协作式探究序列来管理网络,通过这种实践,他们以创造性和实验性的方式界定并解决网络治理和联合网络行动中反复出现的问题。
研究局限/启示:本研究解释了综合医疗网络治理如何以及为何出现和演变,为先前的研究增添了一种动态理论,先前研究在不考虑其时间演变的情况下研究了有效网络治理的决定因素。它还对更广泛的网络文献做出了贡献,提请注意意义建构、创造力和实验对于理解网络治理动态的关键作用。
该研究促使从业者思考如何在自身环境中设计协作式探究。重要的设计杠杆包括创建沟通论坛、信任和信息透明度。
原创性/价值:该研究为综合医疗网络治理增添了罕见的纵向视角。