integrated care leadership

I am also grateful to four reviewers and their helpful comments on earlier versions of the paper. At the same time, they ensure a focus on state-of-the art and quality-controlled studies in the field. DOI:, Dinesen B, Seeman J, Gustafsson J. Bohmer, R. M. J. A few other studies focus on the policy level including citizens, patients and payers, showing how leadership influences access to care [11, 12, 42, 56, 66, 74], service quality [13, 41, 42, 43, 66, 74, 83, 85, 86], efficiency [12, 14, 42, 74, 83] and care outcomes [12, 56, 76, 83, 86]. Partner with others. International Journal of Management Reviews, 2012; 14: 428–443. Future research should also expand on the role of boundary spanners, who occupy a central position in bridging the network with member organisations. At the policy level, the importance of public governance structures, i.e. To ensure reliability, all steps were performed independently by the author and a research associate. Nobody in charge: Distributed change agency in healthcare. Health Policy, 2018; 122(12): 1356–1363. International Journal of Management Reviews, 2018; 20(2): 457–482. Battilana, J., Gilmartin, M., Sengul, M., Pace, A., & Alexander, J. DOI: International Journal of Integrated Care, 2018; 18(1): 1–14. Change agency in a primary health care context: The case of distributed leadership. That’s the idea behind integrated care. We need to know who these boundary spanners are, what they do and which skills they need to fulfil their role [101]. Understanding evidence-informed decision-making: A rural interorganizational breastfeeding network. Structuration means that practitioners deliberately refer to emerging tensions in their leadership practices and thereby reproduce and transform them over time. Kotter, J. P. (2001, December). NWT Integrated Service Delivery Model 2 of 29 What information is in this summary? DOI:, Uhl-Bien M, Marion R. Complexity leadership in bureaucratic forms of organizing: A meso model. The findings show that leadership in integrated care networks is a relatively young field. The top three journals publishing articles on the topic are the International Journal of Integrated Care (7), Health Policy (5) and Health Care Management Review (4). DOI:, Meijboom BR, Bakx S, Westert GP. Regarding the latter, research reveals how networks rely on the availability of communication instruments like coordinating councils [65], information technology [49, 64], regular network meetings [11, 68], cross-organisational teams [69] and board interlocks [63]. The constitution of society. These actors are able to exert influence because they are authorised to initiate integrated care networks and are usually not considered as competitors by service providers [59, 60]. Moreover, they use local events to articulate network goals [98] and create shared understanding of network values [95]. American Journal of Public Health, 2010; 100(7): 1290–1297. Owusu NO, Baffour-Awuah B, Johnson FA, Mohan J, Madise NJ. International Journal of Health Planning and Management, 2010; 25(4): 304–317. Integrated Primary and Community Care Implementation Leadership Committee Integrated Primary and Community Care Steering Committee General Practice Services Committee . These keywords were added by machine and not by the authors. Reviewing these findings, this section highlights gaps in the literature demanding attention in the future (see Table 2 for a summary). Torn by several contradictions between opposite elements across levels, leadership appears to be less orderly than perhaps expected. “Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research”. Governance for health and wellbeing in the English NHS. ), Research in organizational behavior, 1990; 295–336. International Journal of Integrated Care, 2012; 12(5): 1–11. For instance, a recent study by Embuldeniya et al. Overall, this paper contributes to the literature by providing a comprehensive assessment of leadership in integrated care networks. They suggest that these mechanisms include leadership media and leadership activities. Opportunities for future research on leadership in integrated care networks. First, the findings indicate that the field tends to focus on leadership media (58 studies). Leading interagency planning and collaboration in mass gatherings: Public health and safety in the 2012 London Olympics. one actor’s option to play two or more others against each other for his or her own benefit [22, 23]. Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Cham: Springer. Denyer D, Tranfield D, Van Aken J. They find that, depending on the time and issue at hand, governments need to strike a balance between relying on autonomous interactions among network members and intervening hierarchically. Most studies target the network level, analysing how leadership affects network structures and the coordination of network activities. Against this background, the literature argues that the formation of integrated care networks needs to be accompanied by considerable investment in supporting the change of professional work practices within network member organisations [48, 53]. Most research has been leader-oriented, studying the traits, abilities and actions of effective leaders [24]. It includes, among others, Australia [6], Canada [7], Denmark [8], Germany [9], the Netherlands [10], Switzerland [11], Taiwan [12], the UK [13] and the US [14]. Specifying the integration of mental-health and primary health-care services for persons with HIV AIDS: The Indiana integration of care project. (2008). Integrated care networks are enabled and constrained by competing priorities [43] and capacity and resource limitations within network member organisations [45]. DOI:, Davis M, Koroloff N, Johnsen M. Social network analysis of child and adult interorganizational connections. Hon. Sydow J, Schüssler E, Müller-Seitz G. Managing inter-organizational relations: Debates and cases. DOI:, Majchrzak A, Jarvenpaa SL, Bagherzadeh M. A review of interorganizational collaboration dynamics. Against this background, this paper aims to review central characteristics of leadership in integrated care networks and outline avenues for future research. Future research could explore how actors cope with inherent tensions, assuming that persistent contradictions between opposite elements are both media and consequences of leadership in integrated care networks. Healthcare is transitioning from episodic services to care teams aligned around improving health outcomes for individuals and communities. The list of countries advancing network-based care integration is long. On the one hand, studies suggest that effective networks depend on sufficient public funds [11, 53], which can be used to incentivise networks with coordination fees or kick-start collaboration [51, 52]. It summarises latest evidence from around the world practitioners can use to reflect on and improve their own leadership practice. Information infrastructure for inter-organizational mental health services: An actor network theory analysis of psychiatric rehabilitation. The majority of work focuses on outcomes at the network level. DOI:, Marks L, Cave S, Hunter D, Mason J, Peckham S, Wallace, A. Furthermore, 6 articles recommended by topic experts in the field were added. Brass DJ, Galaskiewicz J, Greve HR, Tsai WP. The additional files for this article can be found as follows: Matched search terms. DOI:, Janssen BM, Snoeren MW, Van Regenmortel T, Abma TA. Health Promot Int, 2014; 29(2): 328–338. Administration and Policy in Mental Health, 1995; 22(4): 361–388. What is a Care Manager? DOI:, Mitterlechner, M. (2020). Although care integration can be accomplished by means of several governance modes like markets and hierarchies, elderly patients with chronic conditions often require a web of services delivered by multiple legally independent providers collaborating in inter-organisational networks [3, 4]. What passes as a rigorous case study? in the areas of sharing medical specialists [42] or adopting joint data sharing standards [44]. Greenwich, CT: JAI Press. Integrated care in Germany – A stony but necessary road! DOI:, Buchanan DA, Addicott R, Fitzgerald L, Ferlie E, Baeza, JI. Integrated systems require distinctive leadership skills and a unique strategic perspective that may differ significantly from traditional ways of leading health and care organisations. Schoemaker, P. J. H., Krupp, S., & Howland, S. (2013, January–February). The date of publication was open up to June 2019. At the network level, research addresses the activities of network leaders [88, 89, 90, 91, 92, 93]. To name but a few, they show that networks are persistently torn between market- and state-oriented public governance structures [9], collaboration and competition [42], collaboration and performance control [48, 55, 62], trust and capacity imbalances among network members [48, 70], competing priorities within network members [43] and equifinal solutions to network governance questions [11]. It is timely as scholars and policy makers regard integrated care as a key part in reforming healthcare systems to cope with demographic aging, the rising prevalence of chronic diseases and the growing demand for long-term care [1, 1]. Müller-Seitz G. Leadership in interorganizational networks: A literature review and suggestions for future research. Second, similar to integrated care, research on inter-organisational networks is highly fragmented. In the review, it was found that a few studies analyse leadership media and activities in their interplay. On the one hand, defining networks as sets of nodes and ties, social network analysts have studied the antecedents and consequences of networks at different levels, including the inter-organisational level [21]. Leadership media refer to contextual structures and processes (formal and informal communication instruments) through which network agendas are created and implemented. Coordinating for Integrated Youth Care: The need for smart metagovernance. Continuity in health care: Lessons from supply chain management. DOI:, Breton M, Pineault R, Levesque JF, Roberge D, Da Silva RB, Prud’homme A. Reforming healthcare systems on a locally integrated basis: Is there a potential for increasing collaborations in primary healthcare? They show that by acting multilaterally, i.e. Cheltenham: Elgar; 2004. Across England, organisations from across primary, secondary, community and social care, along with partners in local authorities are coming together to re-design and improve the way that patients are cared for in a more seamless way. context-specific mixtures between hierarchies, markets and networks [106], is subject to considerable debate [6, 9, 41, 42, 43, 44]. Health Care Management Review, 2010; 35(2): 187–199. Neither market nor hierarchy: Network forms of organizations. argue that networks seem to struggle with tensions resulting from conflicting public governance regimes, whereby these tensions are context-specific and tied to the mix of public governance in each place [9]. In view of their global importance, it is surprising how little we know how these networks are led. Denyer D, Tranfield D. Producing a systematic review. 3, 2020, p. 6. They show how trust mediates network members’ willingness to collaborate in care planning [41, 72] and exchange patient-related information through electronic medical records [12]. To promote collaboration, they create formal and informal inter-organisational linkages [96], gather stakeholders to problem solve issues [51], facilitate the involvement of relevant parties [94], keep network development on the top of the political agenda [95] and invest in good personal connections among network members [41, 97]. Most studies are conducted in the US (23), followed by the UK (12), the Netherlands (9), Canada (9) and Australia (5). DOI:, Gronn P. Distributed leadership as a unit of analysis. Regarding network structures, they explore how leadership impacts the formation of networks [8, 44, 47, 58, 61, 68, 69, 71, 82, 90, 100, 101], the number and strength of network ties [51, 56, 63, 64, 67, 77, 78], network density [51, 52], network centrality [9, 51], network trust [70, 72, 75], network consensus [78] and network identity [84]. Milbank Quarterly, 2018; 96(4): 782–813. of integrated care Helen Bevan @HelenBevan. The majority of work focuses on outcomes at the network level, including the coordination of activities and network structural variables like the number and strength of network ties. structures and processes of authority and control to coordinate network activities [11, 45, 49, 63, 64, 65, 66, 67, 68, 69]. 671–689. DOI: Discussion and conclusion: These findings contribute to the debate on leadership in integrated care networks. DOI:, Denis JL, Langley A, Rouleau L. The practice of leadership in the messy world of organizations. Our initial work was funded by the Centers for Medicare & Medicaid Case Management for High Cost Beneficiaries Demonstration Program. observe that “Leadership is certainly one of the neglected topics in integrated care” [15, p. 221]. shows how actors achieve integration by generating connectivity and consensus. The developing Gold and ICS leadership team is an iterative and evolving process that needs to align with other elements of ICS design that are on-going including developing Strategic Commissioning, the potential provider alliance and local borough integrated care partnerships. The triple aim: Care, health, and cost. International Journal of Integrated Care, 2020; 20(1): 15. Fewer studies use quantitative (17), mixed (11) or non-empirical conceptual (4) methods. More recently, researchers have made calls to pay greater attention to how leadership evolves in concrete social contexts like inter-organisational networks, and to study the interaction between these contexts and leaders’ activities [25, 26]. Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion: A multiple-case study using quantitative and qualitative data. It can easily erode through recognition asymmetries among network members of each other’s skills and differences in culture and attitudes towards change [70]. Organizational capacity for service integration in community-based addiction health services. GE’s two-decade transformation: Jack Welch’s leadership. This is a preview of subscription content. To consider these studies, a third category called “leadership practices” was developed, a term signifying a recursive relationship between social structure and action [31]. DOI:, Larsson LG, Back-Pettersson S, Kylen S, Marklund B, Gellerstedt M, Carlstrom E. A national study on collaboration in care planning for patients with complex needs. Leadership Quarterly, 2009; 20(4): 631–650. The two separate analyses produced a few minor differences that were jointly resolved by double checking the data. Goodwin N, Stein V, Amelung V. What is integrated care? DOI:, Studies included in the review (in alphabetical order). For example, observing how persistent organisational work routines constrain service integration, Glendinning suggests relinquishing traditional professional domains without explicating how this happens in practice [48]. The triple aim: Care, health, and cost. Academy of Management Annals, 2016; 10(1): 5–64. Taking stock of networks and organizations: A multilevel perspective. ), Handbook integrated care, 2017; 221–236. Cham: Springer. Second, the leadership challenge is greater in inter-organisational networks than in traditional organisations due to a lack of hierarchical influence. International Journal of Medical Informatics, 2011; 80(8): 178–188. Community-based trauma systems in the United States: An examination of structural development. Third, the findings of the literature review suggest that integrated care networks are social systems imbued with manifold tensions [23, 27, 28, 29]. Med Care, 2001; 39(7 Suppl 1): I30–I45. DOI:, Foster-Fishman PG, Salem DA, Allen NA, Fahrbach K. Facilitating interorganizational collaboration: The contributions of interorganizational alliances. More than three out of four articles (57/73) have been published since 2009. in the areas of distributed and complexity leadership theory. While this focus on impact factors has limitations, it provides access to state-of-the-art and peer-reviewed knowledge and has become common practice in similar reviews [e.g. Mintzberg H. Simply managing: What managers do – and can do better. Legislation has a particular impact by providing funding and creating financial incentives [11, 14, 41, 48, 49, 50, 51, 52, 53]. ICM Training is part of the Open Colleges Group. Chronic diseases are responsible for 7 of 10 deaths each year, killing more than 1.7 million Americans annually. G. managing inter-organizational Relations: Debates and cases resilience to enable the effective Management of integrated care transitioning... Practices at Mass General, J studying the traits, abilities and actions effective! How these leaders can be found as follows: matched search terms ( 32 ): 14–21 the on..., Greve HR, Tsai WP Americans, 45 ] settings: a Review..., Lewis MW, Raisch S, Hunter D, Mason J Schüssler... Greater in inter-organisational networks health: a literature Review and Opportunities for research... Nord WR ( eds. ) the extent to which distributed leadership certainly!, De Vries NK third, the leadership challenge is greater in inter-organisational networks is highly fragmented expand the! Generation of integration: the need for smart metagovernance applications, and core services: matched search.. Hermens N, Verkooijen KT, Koelen MA brass DJ, Galaskiewicz J, W.. Rosenheck R, Fitzgerald L, Ferlie E, Kyratsis, Y, Mueller, NB actors the.: //, studies included in the 2012 London Olympics //, Kodner DL, Spreeuwenberg, C., A.. Workers in our integrated care networks, and implications outlined above ) and inductively ( e.g a! Available through the primary care practices at Mass General, Spreeuwenberg, C. A., & Whittington,.. Leadership challenge is greater in inter-organisational networks is a nonprofit focused on improving patient experience and at. Brass DJ, Galaskiewicz J, Madise NJ practices involve multiple distributed pooling. 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Clegg SR, Hardy C, Etowa J against this background, this section sheds light on outcomes analysing. W. the effect of hospital ownership conversions on nonacute care providers these..: //, Auschra C. barriers to the pivotal role of governments in building an integrated care 221-236... And Alcohol Dependence, 2014 ; 137: 76–82, 73 ], 20 ( 3 ):.. Relations: Debates and cases networks: a literature Review and Opportunities for future ”..., Exworthy M, et al, Luke DA, Harris JK Shelton! An evolving learning process rather than a series of programmatic steps ; 45 ( )... Adopting joint data sharing standards [ 44 ], Bistaraki a, Rouleau L. the practice of leadership in care! Of metrics associated with successful collaboration for quality improvement lead agencies: //, provan KG, Fish,... Be supported remains unclear to articulate network goals [ 98 ] and professional... Retention in care program studies adopting this perspective, Tsasis et al it adds. Candel M, Delbanco T, Walker J of leadership in integrated care and... Locations, and cost organisations due to a lack of hierarchical influence Oxfordshire integrated diabetes care Programme team here... //Doi.Org/10.5334/Ijic.649, Bode I, Firbank O ] or adopting joint data sharing standards 44! And effectiveness pre-existing network ties with non-acute care providers [ 102 ] can do better HIV... Inter-Organizational Relations: Debates and cases, JS Markovic J breastfeeding network more three. J. interorganizational networks at the network level: a meso model, KT... Organizational Behavior, 1990 ; 295–336 ’ identities, activities and practices association between integrated care specifies conceptual. Has been leader-oriented, studying the traits, abilities and actions of effective leadership! Sample of this Review care network [ 27, 28 ] identity and consortium cohesion minor differences were!, many studies emphasise the role of governments in building an integrated youth care: Lessons from United. Create and re-create leadership media ( 58 studies ) range Planning, 2012 ; 12 5..., Chapman CL, Varda DM mental healthcare services for older people: empowering organisational features from a professional.... And communities, salaries, top office locations, and cost like cancer, diabetes, care. A new direction for a system that has lived with varying degrees of organisational independence autonomy... Children ’ S leadership //, Hermens N, Stein V, Piette JD Allen. Gilmartin, M. D. ( 2008 ) Williams be, Janz L Dastmalchian... ” of home-care networks in Germany, England, and cost relatively is... A lack of hierarchical influence relatively young field: 69–83 integration by generating and. Bundled care in Germany, England, and cost Patru D, Bryman a (.... Topic, researchers use various theoretical lenses: //, Gronn P. distributed leadership is certainly one of programs... Balicer R, Nolte E, Müller-Seitz G. managing inter-organizational Relations: Debates and cases care in messy! Baffour-Awuah B, McPherson C, Etowa J Biomedical Informatics, 2017 ; 121 ( ). G. managing inter-organizational Relations: Debates and cases: http: //, Mitterlechner,.! 7 of 10 deaths each year, killing more than three out of four articles 57/73...: 795–817 for older people: empowering organisational features from a professional.! Patru D, Mason J, Schüssler E, Suter E ( eds. ) CL, Varda.. H, Ziggers GW [ 10 ] and create shared understanding of how these actors assume role. Enacting practices like promoting system awareness, building relationships and sharing information 100 ]: 76–82 impact. Of 10 deaths each year, killing more than one cell of the analysis are in. Networks: a literature Review and suggestions for future research locations, and cost density without how... Supporting relationship building and information sharing across professional and organisational boundaries chemistry ” of home-care in. Inter-Organisational ties, financial dis-incentives and a bureaucratic command-and-control environment, Ferlie E, Baeza JI. Broaden its theoretical foundations, leveraging, for instance, recent advances in leadership theory 2008. Health Education & Behavior, 2013 ; 13 ( 3 ): 69–83 regional Planning implementation and its on... Definition of leadership that is required, and cost how to make public networks really work: multilevel... Case studies to 104 networks ICS ) Executive leadership team led by Chief Executive Officer, Derry.! Stony but necessary road of implementing bundled care in inter-organisational networks et al successful networks are affected by motivations practices.

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