Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue
Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue
复制标题
DOI：
10.5334/ijic.4684
复制
发表时间：
2020-01-01
影响因子：
2.4
通讯作者：
Shaw, James
中科院分区：
文献类型：
--
作者：
Gordon, Dara;McKay, Sandra;Shaw, James
导言：综合保健是许多医疗保健系统的目标。然而，综合保健的运作和实施仍然具有挑战性，特别是在不断演变的政策环境中。我们报告了2017年在加拿大安大略省举行的一次政策研讨会，该研讨会的重点是在加拿大安大略省政策演变的背景下实施特定的综合医疗政策。方法：45名与会者参加了研讨会，其中包括政府雇员、医疗保健领导人、研究人员、临床医生和患者代表。专题讨论会包括各小组代表的发言和分组会议。两名训练有素的观察员记录了实地观察记录。结果：我们报告了关于政策实施的4项建议和14项子建议。讨论：我们概述了如何通过协作治理来加强这些建议，并确定了该框架可以在哪些方面支持与实施综合护理相关的治理和领导挑战。我们描述了在不断变化的政策环境中努力实现这些目标所带来的独特挑战。结论：我们利用协作治理来为实施综合护理的领导人提供见解，并通过解决在不稳定的政策环境下保持协作治理倡议的重要性来得出结论。
Introduction: Integrated care is a goal of many health care systems. However, operationalizing and implementing integrated care remains challenging especially in continuously evolving policy environments. We report on a policy symposium held in 2017 focused on operationalizing a particular integrated care policy in the context of policy evolution in Ontario, Canada.Methodology: Forty-five participants attended the symposium including government employees, health care leaders, researchers, clinicians, and patient representatives. The symposium included presentations from representatives of each group and breakout sessions. Two trained observers recorded observational field notes.Results: We report four recommendations and fourteen sub-recommendations which arose regarding the implementation of the policy. We highlight four important tensions which characterize challenges regarding its implementation, and discuss the recommendations in the context of Collaborative Governance.Discussion: We outline how the recommendations could be strengthened by collaborative governance and identify where this framework could support governance and leadership challenges associated with implementing integrated care. We describe the unique challenges posed by working towards these goals in an evolving policy environment.Conclusion: We draw on collaborative governance to generate insights for leaders implementing integrated care and conclude by addressing the importance of maintaining collaborative governance initiatives under circumstances of unstable policy environments.