Waring Justin, Bishop Simon, Black Georgia, Clarke Jenelle, Roe Bridget
Health Services Management Centre, University of Birmingham, Birmingham, UK
Centre for Health Innovation, Leadership and Learning, University of Nottingham, Nottingham, UK.
BMJ Lead. 2023 Mar 8;7(4). doi: 10.1136/leader-2022-000709.
Integrated care systems present enduring governance challenges associated with fostering interorganisational collaboration.
To understand how clinical leaders can make a distinct contribution to the governance and system leadership of integrated care systems.
A qualitative interview study carried out between 2018 and 2019 with 24 clinical leaders, and a further 47 non-clinical leaders, involved in the governance of three Sustainability and Transformation Partnership in the English National Health Service.
Clinical leaders were found to make four distinct contributions: (1) making analytical insights into integration strategies that ensured their relevance and quality to clinical communities; (2) representing the views of clinicians in system decision-making thereby enhancing the legitimacy of change; (3) translation and communication activities to articulate integration strategies in favourable ways and ensure clinical engagement; and (4) relational work in the form of brokering and building connections and mediating conflict between multiple stakeholders. These activities varied across the levels of system governance and at different stages in the processes of change.
Clinical leaders can make a distinct contribution to the governance and leadership of integrated care systems based on their clinical expertise, membership professional networks, reputation and formal authority.
综合医疗体系面临着与促进组织间合作相关的长期治理挑战。
了解临床领导者如何能对综合医疗体系的治理和体系领导做出独特贡献。
2018年至2019年间，对参与英国国家医疗服务体系中三个可持续性与转型伙伴关系治理的24名临床领导者以及另外47名非临床领导者进行了定性访谈研究。
发现临床领导者做出了四项独特贡献：（1）对整合策略进行分析性洞察，确保其对临床群体的相关性和质量；（2）在体系决策中代表临床医生的观点，从而增强变革的合法性；（3）进行翻译和沟通活动，以有利的方式阐述整合策略并确保临床参与；（4）以促成和建立联系以及调解多个利益相关者之间冲突的形式开展关系工作。这些活动在体系治理层面以及变革过程的不同阶段有所不同。
临床领导者凭借其临床专业知识、成员专业网络、声誉和正式权威，能够对综合医疗体系的治理和领导做出独特贡献。
