Collaborative Governance in the Age of Managed Behavioral Health Care

Spitzmueller, Matthew C.; Jackson, Theodore; Warner, Lynn A.

doi:10.1086/712099

Cited by 2 publications

(7 citation statements)

References 32 publications

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“…Examples are ‘hospital territorial groups’ in France ( Tourmente, 2016 ), accountable care organizations in the USA ( Field et al ., 2020 ) and hospital networks in Spain ( Bernardo et al ., 2012 ). Other integrated HN included, besides hospitals, different types of healthcare providers such as primary care and social care facilities in Canada ( Breton et al ., 2013 ), Italy ( Romiti et al ., 2018 ), Portugal ( Franco and Duarte, 2012 ), The Netherlands ( Van Der Schors et al ., 2021 ; de Regge et al ., 2019 ) and in the USA ( Spitzmueller et al ., 2020 ). Many multidisciplinary networks were organized according to the scope of services provision around specific high-priority health programmes (traumatology, mental health) ( Nicaise et al ., 2013 ), palliative care, chronic obstructive pulmonary disease (COPD) and oncology networks in Quebec ( Wankah et al ., 2018 ; Tremblay et al ., 2019 ) and in Poland ( Sus et al ., 2019 ) and maternal neonatal care in Tanzania ( Sequeira D’mello et al ., 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…At the early formation stage of the health networks, most included studies referred to the importance of principled engagement (i.e. mutual commitment) in explaining the willingness of HN actors to share healthcare information ( Lyngsø et al ., 2016 ; Hermans et al ., 2019 ; Larsen et al ., 2021 ; Madsen et al ., 2021 ) and to actively participate in the collective decision making processes (steering committees) ( Audet and Roy, 2016 ; Lyngsø et al ., 2016 ; Frankowski, 2019 ; Spitzmueller et al ., 2020 )( de Vries et al ., 2019 ). For instance, in The Netherlands, Belgium and Canada, participatory governing bodies named ‘strategic communities’ allowed the creation of enabling conditions for participatory decision-making and improved mutual understanding and principled engagement of HN members ( Audet and Roy, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

“…Scholars asserted that leadership increases shared motivation and fosters mutual commitment and collaborative dynamics over time ( Klinga, 2018 ; Spitzmueller et al ., 2020 ; Vindrola-Padros et al ., 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…Implementing HN sometimes transformed health policy processes and the system context ( Karlsson et al ., 2020 ; de Pourcq et al ., 2019 , Mervyn et al ., 2019 ). HN facilitate the implementation of healthcare policies that address the significant threats to health systems ( Spitzmueller et al ., 2020 ) and can have a transformative impact. This impact includes changing the market structure and the reduction of rivalry among healthcare providers ( Sarcone and Kimmel, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Unravelling collaborative governance dynamics within healthcare networks: a scoping review

Belrhiti,

Bigdeli,

Lakhal

et al. 2024

Health Policy and Planning

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In many countries, healthcare systems suffer from fragmentation between hospitals and primary care. In response, many governments institutionalised healthcare networks (HN) to facilitate integration and efficient healthcare delivery. Despite potential benefits, the implementation of HN is often challenged by inefficient collaborative dynamics that result in delayed decision-making, lack of strategic alignment and lack of reciprocal trust between network members. Yet, limited attention has been paid to the collective dynamics, challenges, and enablers for effective inter-organisational collaborations. To consider these issues, we carried out a scoping review to identify the underlying processes for effective inter-organisational collaboration and the contextual conditions within which these processes are triggered. Following appropriate methodological guidance for scoping reviews (Arksey and O Malley, 2005), we searched four databases (PubMed (n=114), Web of Science (n=171), Google Scholar (n=153), and Scopus (n=52) and snowballing (n=22)). Thirty-seven papers addressing HN including hospitals were included. We used a framework synthesis informed by the (Emerson, 2011) collaborative governance framework to guide data extraction and analysis, while being sensitive to emergent themes. Our review showed the prominence of balancing between top-down and bottom-up decision-making (e.g., strategic versus steering committees), formal procedural arrangements, and strategic governing bodies in stimulating participative decision-making, collaboration, and sense of ownership. In a highly institutionalised context, the inter-organisational partnership is facilitated by pre-existing legal frameworks. HN are suitable for tackling wicked healthcare issues by mutualising resources, staff pooling and improved coordination. Overall performance depends on the capacity of partners for joint action, principled engagement and a closeness culture, trust relationships, shared commitment, distributed leadership, power sharing and interoperability of information systems. To promote effectiveness of HN, more bottom-up participative decision-making, formalisation of governance arrangement and building trust relationships are needed. Yet, there is still inconsistent evidence on the effectiveness of HN in improving health outcomes and quality of care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Unravelling collaborative governance dynamics within healthcare networks: a scoping review

Belrhiti,

Bigdeli,

Lakhal

et al. 2024

Health Policy and Planning

View full text Add to dashboard Cite

show abstract

“…Although this realist synthesis commenced with an initial view that stakeholder groups include service users, the literature on change in funding for community mental health services has been largely silent on evaluations, processes or best practices for including the voice of service users in the planning process for funding changes or funding allocations. Engagement of service user groups and their families are considered constructive collective governance strategies, 49 however, future research is required as to how to do this in a meaningful way.…”

Section: Discussionmentioning

confidence: 99%

Community mental health funding, stakeholder engagement and outcomes: a realist synthesis

et al. 2023

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Mental health services continues to be a high priority for healthcare and social service systems. Funding structures within community mental health settings have shown to impact service providers’ behaviour and practices. Additionally, stakeholder engagement is suggested as an important mechanism to achieving the intended goals. However, the literature on community mental health funding reform and associated outcomes is inconsistent and there are no consistent best practices for stakeholder engagement in such efforts.ObjectivesThis study sought to understand how stakeholder engagement impacts outcomes when there is a change in public funding within community mental health settings.DesignA realist synthesis approach was used to address the research question to fully understand the role of stakeholder engagement as a mechanism in achieving outcomes (system and service user) in the context of community mental health service reform. An iterative process was used to identify programme theories and context–mechanism–outcome configurations within the literature.ResultsFindings highlight that in the absence of stakeholder engagement, funding changes may lead to negative outcomes. When stakeholders were engaged in some form, funding changes were more often associated with positive outcomes. Stakeholder engagement is multifaceted and requires considerable time and investment to support achieving intended outcomes when funding changes are implemented.ConclusionsTo support successful transformation of community mental health programmes, it is important that stakeholders are meaningfully engaged during funding allocation changes. Stakeholder engagement may entail connecting around a shared purpose, individual participation and meaningful interactions and dialogue.

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Collaborative Governance in the Age of Managed Behavioral Health Care

Cited by 2 publications

References 32 publications

Unravelling collaborative governance dynamics within healthcare networks: a scoping review

Unravelling collaborative governance dynamics within healthcare networks: a scoping review

Community mental health funding, stakeholder engagement and outcomes: a realist synthesis

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