Integrated care management: applying control theory to networks

Raak, Arno van; Paulus, Aggie; Merode, Frits van; Mur-Veeman, Ingrid

doi:10.1108/02689239910299795

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…The system of health care networks is based on the principles of health promotion, prevention, primary health care, and the effective treatment of health conditions (1)(2)(3)(4)(5)(6)(7). To provide effective responses to the population regarding health systems, countries such as the United States, England, the Netherlands, Sweden, Brazil, and others have established integrated health networks (2,3,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Analysis of the oral health care network development in Minas Gerais state, Brazil

Leal

Martins

Carneiro

et al. 2019

J Public Health Dent

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Objectives This study aimed to analyze the development stage of the oral health care network of the Brazilian Unified Health System in the state of Minas Gerais, Brazil. Methods A cross‐sectional descriptive and analytical study was conducted with 205 municipal oral health coordinators from the state. Data collection was carried out through a validated questionnaire to analyze the state of development of the oral health care network. Descriptive and cluster analysis were performed, and two clusters were generated. Results The total median score of the questionnaires classified Minas Gerais as a state with incipient oral health care networks and a minimal capacity to operate such networks, reflected in the predominance of cluster 1 in the sample. There was no statistical association between age, time since graduation, and time spent working as a coordinator and the clusters (Mann–Whitney test). The coordinators’ gender and educational level were also not statistically associated with the clusters (Pearson's chi‐square and Fisher's exact, respectively). Conclusion There is a great need to improve the organization of services of the oral health care network in Minas Gerais. This can be done through improvements in its operational structure, as well as investment in management training.

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Section: Introductionmentioning

confidence: 99%

Analysis of the oral health care network development in Minas Gerais state, Brazil

Leal

Martins

Carneiro

et al. 2019

J Public Health Dent

View full text Add to dashboard Cite

show abstract

“…There is unlikely to be a universal set of process PIs that would suit every particular PCP, and hospitals may need to be encouraged to develop their own process PIs within the specific context of a clinical specialty and according to locally shared meanings. Hospitals and other health care organizations need to retain relative independence from external interventions in order to exercise flexibility in redesigning the PCP according to their own specific combination of strengths and weaknesses (van Raak et al, 1999). Managers need to decide what should Recommendation towards redesigning the PCP Examples from the case study of an unsuccessful attempt to redesign the PCP The source of the perceived problem needs to be identified.…”

Section: Discussion and Recommendations For Practicementioning

confidence: 99%

Process performance indicators in redesigning the patient care process

Gospodarevskaya

Чурилов²

2011

Business Process Management Journal

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Purpose -The purpose of this paper is to investigate the regulator's attempt at redesigning the patient care process (PCP) -a core business process in public hospitals -by introducing dichotomous process performance indicators as an innovative management tool intended to align the State health care policy with the everyday management of operations at a hospital ward. Design/methodology/approach -The paper presents an ethnographic case study of redesigning the PCP according to the strategy originating outside the organization. The study employs competing theories that represent alternative epistemological and ontological views of the world in order to produce a tentative explanation of why the intended redesign of the PCP has not fully eventuated. Observational data and opportunistic interviewing are used to answer the research question of whether and how the information and operational flows on the ward were affected by introduction of process performance indicators. A business process redesign framework was employed for data analysis since it better reflects the objectives of the State-wide initiative and offers a convenient tool in dealing with data complexity. Findings -Introduction of the process performance indicators did not result in redesigning of the PCP as intended by health care authorities. Out of four process performance indicators, only one was consistently implemented, which merely produced a duplication of the previously collected information, therefore adding no value to the PCP. On a theoretical level, the results indicate that the emergent theory rather than the rational agent theory demonstrated a greater fidelity to the empirical observations. Originality/value -The paper assessed the feasibility of using innovative dichotomous process performance indicators as a tool for redesigning the business process at the ward level, in order to achieve macro-level policy objectives. The failure to successfully implement a top-down universal approach to redesigning business processes in health care is likely to reflect a lack of appreciation of emergent rationality that characterizes essential aspects of the PCP.

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“…Furthermore, Rummery [7] cautions about the lack of evidence with respect to the success of health care networks. A number of studies have already contributed to closing the gap in research on how health care networks should be structured and managed; such as Lin [8], van Raak et al [9], D’Amour et al [10], and McInnes et al [11]. While these are important contributions that also emphasize the relevance of organizational aspects in the success of health care networks, they do not focus on the governance part.…”

Section: Introductionmentioning

confidence: 99%

Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

Willem

Gemmel

2013

BMC Health Serv Res

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BackgroundHealth care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness.MethodsThe study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for.ResultsNeither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors.ConclusionsAlthough the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.

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Integrated care management: applying control theory to networks

Cited by 16 publications

References 10 publications

Analysis of the oral health care network development in Minas Gerais state, Brazil

Analysis of the oral health care network development in Minas Gerais state, Brazil

Process performance indicators in redesigning the patient care process

Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

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