Hallberg Anna, Winblad Ulrika, Fredriksson Mio
Health Services Research, Department of Public Health & Caring Sciences, Uppsala University, Sweden.
Int J Integr Care. 2021 Sep 27;21(3):14. doi: 10.5334/ijic.5635. eCollection 2021 Jul-Sep.
Networks constitute a promising strategy for interorganisational collaboration, but may fail due to network tensions. By investigating the activities and internal dynamics of a voluntary meso-level network operating in the intersection of health and social care, this study aims to enhance the understanding of the relationship between pragmatism and sustainability and the role network governance plays in this respect.
In this descriptive case study, 2-3 researchers observed 3 three-hour long network meetings during the course of a year, and four complementary interviews were performed. Data were analysed based on the literature on network functioning and effectiveness.
Pragmatism (a focus on 'getting things done') was more emphasised than sustainability although the network meetings also contained elements of relationship- and trust-building. The network leadership (a Network Administrative Organisation, NAO) created structure and concretized the participants' ideas while remaining flexible and perceptive, and also carried out tasks which would otherwise not have been performed.
The emphasis on pragmatism did not seem to influence sustainability negatively which has been pointed out as a potential risk in previous literature. Rather, the focus on pragmatism reinforced sustainability in a way that is similar to what has been described in prior research as a "trust-building loop" and discussed further in terms of a "perception of progress" mechanism. However, it was unclear what future the voluntary network would have without the NAO.
Network governance is instrumental to success, and should be carefully considered when initiating interorganisational network initiatives for integrated care.
网络构成了组织间合作的一种很有前景的策略，但可能会因网络张力而失败。通过调查一个在卫生与社会护理交叉领域运作的自愿性中观层面网络的活动及内部动态，本研究旨在增进对实用主义与可持续性之间关系以及网络治理在这方面所起作用的理解。
在这个描述性案例研究中，2至3名研究人员在一年时间里观察了3次时长为三小时的网络会议，并进行了4次补充访谈。基于有关网络运作和有效性的文献对数据进行了分析。
尽管网络会议也包含关系建立和信任构建的元素，但实用主义（专注于“把事情做好”）比可持续性更受强调。网络领导层（一个网络管理组织，NAO）创建了架构并将参与者的想法具体化，同时保持灵活性和洞察力，还执行了一些原本不会有人去做的任务。
对实用主义的强调似乎并未对可持续性产生负面影响，而在先前文献中这被指出是一个潜在风险。相反，对实用主义的关注以一种类似于先前研究中所描述的“信任构建循环”的方式强化了可持续性，并在“进展感知”机制方面进行了进一步讨论。然而，不清楚没有NAO这个自愿性网络的未来会怎样。
网络治理对成功至关重要，在发起组织间综合护理网络倡议时应仔细考虑。
