Session Information
32 SES 03 A, Organizational Learning in Health Care Networks and Inclusive Companies
Paper Session
Contribution
Healthcare is discussed as in need of network development [1]. With the vision of “integrated care”, the formation of networks is regarded as a valuable concept for organizing healthcare services [1]. Establishing such ‘integrated’ healthcare-networks is seen as an option to improve care services, enhance access to care, reduce costs and increase overall population health [2]. Lately, the COVID-19 pandemic has drastically highlighted the need for more integrated healthcare networks [3].
In health sciences, integrated healthcare frameworks or models are understood as concepts that aim to connect fragmented care systems in order to improve healthcare delivery [4]. Such concepts often describe ‘optimal’ integrated care structures and are a central topic to the discourse on integrated care [1]. While it has been acknowledged that a systematic approach is required when establishing such networks [1], no systematic and process-orientated approach has been described so far. However, such a perspective is of utmost importance, since specific challenges arise when trying to establish network structures which, in the worse, can lead to "network failure" [5].
The contribution will show that healthcare research so far follows more technocrat and normative conceptualizations and is lacking consistent theoretical, process- and consultancy-oriented perspectives.
The paper therefore argues, in which ways organizational education (OE) research may offer valuable contributions to the field of health science, support a deeper understanding of the dynamics and preconditions of integrated care networks:
Firstly, OE understands networks as complex organizational networks comprising various actors under a collective goal that only can be followed together - but nevertheless has to deal with multiple and diverse interests and actors´ perspectives [6]. A processual perspective supports a closer look at the formation of healthcare networks. Applying a micrological perspective on practices can contribute to the goal of adaptive healthcare delivery [3].
Second, a practice-based process perspective [7] leads to the question of strategy building, since it understands networks as complex and filled with diverse power relations. Strategy building has been acknowledged as crucially important for addressing health threats, such as the COVID-19 pandemic [3]. From an OE perspective, cooperative networking and work with such a vision has to be understood as collective strategy development [8]. Thus, it can be argued that collective strategy development is of utmost importance for fostering the theoretical understanding and the emergence of healthcare networks.
Third, considering the multiplex and heterogeneous nature of healthcare networks to develop, OE discourse perspectives on change offer a deeper understanding of power and knowledge relations in the medical and health fields. From a discourse-theoretical point of view [9], the endeavor of network development and the vision of integrated care will have to deal with epistemological boundaries, which need to be addressed. In order to move towards strategic healthcare network development, transepistemic boundaries have to be considered and addressed [10].
As in health science, those research perspectives so far are neglected, OE research perspectives offer groundbreaking potentials for healthcare network research and development. OE contribution can further be seen not only in the transepistemic design approaches [11] and the large group interventions to support network transformation, but in the approaches of OE network consultancy, which offers conceptualizations, which are still missing in health care research. In fact, organizational and network consultancy has been described as of special importance for the promotion and long-term establishment of cooperative networks [12].
From the starting point of a systematic review of health science-based frameworks of integrated care, the potential and contribution of OE theories and approaches is discussed as an opportunity for knowledge transfer into the field of integrated care, which so far misses systematic and processual approaches for healthcare network development.
Method
The aim of the article is to identify epistemological boundaries in the field of healthcare networking and to discuss organizational education research potentials of network development and network consultancy. In order to fulfil this aim, a systematic literature review is performed [13,14]. The review will compromise publications from the field of health sciences that propose a framework/ model or guide for establishing an integrated care network. Hereby, an integrated care model will be understood as concept which aims to connect fragmented care systems in order to improve care delivery [4]. The search will cover relevant databases for health sciences: MEDLINE, Web of Science, CINAHL Plus and ERIC. Additionally, the search will cover frameworks of integrated care networks, published by international and national health organizations. The analysis will include English literature (original and translated), with no geographically or timely restriction and will be performed as an undirected content analysis. Finally, the potentials of organizational education approaches of network theory, network development and network consultancy based on the results will be discussed.
Expected Outcomes
Based on empirical evidence and experiences from global health challenges, the formation of integrated healthcare networks on multiple levels is a desirable development goal for various healthcare systems [1-4]. OE research may offer valuable contributions to the field of health science. Applying a consistent theoretical, process-orientated, strategic and discourse perspective on the formation of networks can support a deeper understanding of the dynamics as well as the preconditions of integrated care networks. However, up until today, these research perspectives are not integrated into the field of healthcare network formation. Thus, the systematic analysis of existing models and frameworks of integrated care networks in the field of health sciences may deliver valuable insights into what potentials OE research perspectives have to offer for establishing a systematic approach for healthcare network development. By analyzing existent frameworks and models of integrated care, this contribution opens the field of healthcare for questions of organizational change and points out potentials for creating chances for future development and learning.
References
[1] World Health Organization - Regional Office for Europe [WHO Europe]. (2016). Integrated care models: an overview (Working Document). Accessed 08.Dec.2020 from: https://www.euro.who.int/__data/assets/pdf_file/0005/322475/Integrated-care-models-overview.pdf. [2] Gröne, O., & Garcia-Barbero, M. (2001). Integrated care: a position paper of the WHO European Office for Integrated Health Care Services. International journal of integrated care, 1. [3] World Health Organization - Regional Office for Europe [WHO Europe]. (2020). Strengthening the Health System Response to COVID-19 (Policy Brief). Accessed 08.Dec.2020 from: https://apps.who.int/iris/handle/10665/333072. [4] Goodwin, N. (2016). Understanding integrated care. International journal of integrated care, 16(4). [5] Messner, D. (1994). Fallstricke und Grenzen der Netzwerksteuerung. PROKLA. Zeitschrift für Kritische Sozialwissenschaft, 24(97), pp. 563-596. [6] Weber, S. M. & Schwarz, J. (2011). Führung in interorganisationalen Netzwerken. In: M. Göhlich, S.M. Weber, C. Schiersmann & A. Schröer (eds), Organisation und Führung – Beiträge der Kommission Organisationspädagogik. Wiesbaden: VS. [7] Elven, J. & Schwarz, J. (2018). Praxistheoretische Grundlagen der Organisationspädagogik. In: M., Göhlich; A., Schröer, Andreas, S. M. Weber (eds), Handbuch Organisationspädagogik. Wiesbaden: VS. [8] Weber, S. M. (2018). Strategieentwicklung als Gegenstand der Organisationspädagogik. In: M., Göhlich; A., Schröer, Andreas, S. M. Weber (eds), Handbuch Organisationspädagogik. Wiesbaden: VS. [9] Weber S. M. & Wieners S. (2018). Diskurstheoretische Grundlagen der Organisationspädagogik. In: M., Göhlich; A., Schröer, Andreas, S. M. Weber (eds), Handbuch Organisationspädagogik. Wiesbaden: VS. [10] Weber, S. M., & Heidelmann, M.-A. (2021/i.E.). Im Dispositiv ‚Diskursiver Gestaltung‘: Grenzüberschreitung als Telos organisationspädagogischer Professionalisierung im Feld der Organisations- und Netzwerkberatung. In: A. Schröer, K. Köngeter, S. Manhart, C. Schröder & T. Wendt (eds), Organisation über Grenzen. Jahrbuch Organisationspädagogik. Wiesbaden: Springer. [11] Keller, A., Weber, S. M. (2020): Trans-epistemic design research: Theorizing design within cognitive assistive systems and industry 4.0. In: Proceedings of the Design Society: DESIGN Conference, 1, pp. 627-636. [12] Schwarz, J., & Weber, S. M. (2011). Netzwerksupport durch Netzwerkberatung. Report Zeitschrift für Weiterbildungsforschung, pp. 37–46. [13] Damarell, R. A., Lewis, S., Trenerry, C., & Tieman, J. J. (2020). Integrated Care Search: development and validation of a PubMed search filter for retrieving the integrated care research evidence. BMC medical research methodology, 20(1), 12. [14] Neuendorf, K. A., & Kumar, A. (2015). Content analysis. The international encyclopedia of political communication, pp. 1-10.
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