Miller Robin, Stein K Viktoria
University of Birmingham, UK.
International Foundation for Integrated Care, UK.
Int J Integr Care. 2020 Feb 26;20(1):7. doi: 10.5334/ijic.5440.
The importance of management to the implementation of integrated care is recognised in evidence and practice. Despite this recognition, there is a lack of clarity about what 'good' management of integrated care looks like, if the competences are different to management for 'traditional' care, and how such competences can be acquired.
This exploratory study is based on qualitative interviews with participants with extensive experience of implementing integrated care in senior professional, research, administrative and/or policy roles. It conceptualises management as working at 'strategic' and 'operational' levels.
Management of integrated care was seen to require an ability to create networks across professions and organisations, to be comfortable with distributing responsibilities, and to thoroughly understand the wider system. Competences to support these new ways of working included an understanding of how to implement people-centredness, to have courage to challenge the status quo, and to demonstrate humility to learn from others. Structured development opportunities for managers were lacking, but seen as vital for the sustainability of change.
Management for integrated care remains an underdeveloped concept and practice. A first formulation of the competences necessary was achieved, but more work is urgently required to understand how to better prepare and support managers to achieve necessary changes in practice and culture.
管理对综合护理实施的重要性在证据和实践中得到了认可。尽管有这种认可，但对于什么是“良好”的综合护理管理、其能力是否与“传统”护理管理不同，以及如何获得这些能力，仍缺乏明确认识。
本探索性研究基于对在高级专业、研究、行政和/或政策角色中具有丰富综合护理实施经验的参与者进行的定性访谈。它将管理概念化为在“战略”和“运营”层面开展工作。
综合护理管理被认为需要具备跨专业和组织建立网络的能力、乐于分配责任的态度以及对更广泛系统的透彻理解。支持这些新工作方式的能力包括理解如何以人为本、有勇气挑战现状以及表现出向他人学习的谦逊态度。管理人员缺乏结构化的发展机会，但这被视为变革可持续性的关键。
综合护理管理仍然是一个发展不完善的概念和实践。我们首次明确了所需的能力，但迫切需要开展更多工作，以了解如何更好地培养和支持管理人员，使其在实践和文化方面实现必要的变革。
