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Available. Open Access. Open Access
Article
Publication date: 26 March 2018

Betty Steenkamer, Caroline Baan, Kim Putters, Hans van Oers and Hanneke Drewes

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired…

2688

Abstract

Purpose

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

Design/methodology/approach

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

Findings

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

Practical implications

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

Originality/value

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

Details

Journal of Health Organization and Management, vol. 32 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 7 April 2020

Betty Steenkamer, Esther de Weger, Hanneke Drewes, Kim Putters, Hans Van Oers and Caroline Baan

The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social…

4925

Abstract

Purpose

The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.

Design/methodology/approach

Following the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.

Findings

Five initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.

Originality/value

The study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.

Details

Journal of Health Organization and Management, vol. 34 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 13 August 2024

Natascha van Vooren, Esther de Weger, Josefien de Bruin and Caroline Baan

There is growing recognition that transformation of healthcare systems towards health and well-being systems requires a continuous learning process. This explorative study aims to…

204

Abstract

Purpose

There is growing recognition that transformation of healthcare systems towards health and well-being systems requires a continuous learning process. This explorative study aims to gain insight into the experiences with and investment in these learning processes within regional partnerships for health and in what they need to enhance their learning capacity to use the learning for transformation.

Design/methodology/approach

17 interviews were held with programme managers, data scientists, trusted advisors and a citizen representative, all involved in the learning process on a regional level in ten Dutch regional partnerships. The interviews were inductively and thematically analysed, focusing on the experiences and perceptions underlying the learning processes.

Findings

Regional partnerships invest in learning processes by organizing interactions between different groups of stakeholders and by reflecting on specific themes or on a region-wide level. Difficulty was found in region-wide reflection and in enhancing the learning capacity within the partnerships. Further enhancing the learning capacity required: (1) Investment in (the use of) expertise for translating learning outcomes into concrete action; (2) Leadership for change, underpinned by a shared sense of urgency to learn for transformation and (3) A facilitative environment for change which is both based on facilitative system structures and a basis of trust and commitment to learn and adapt.

Originality/value

The study highlighted the difficulty of learning on a region-wide level and the struggle to apply this learning for transformation. It provides insights into how learning processes and learning capacity can be further improved.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 26 December 2024

Paul Olaitan

The paper seeks to assist public sector leaders to take a balanced and impactful approach to transformation programmes which aim to deliver integrated healthcare. The paper…

273

Abstract

Purpose

The paper seeks to assist public sector leaders to take a balanced and impactful approach to transformation programmes which aim to deliver integrated healthcare. The paper highlights the balance of attention paid in these programmes across elements of leadership, strategy, structure and people, and aims to highlight where this balance can sit to encourage more successful and sustainable transformations, with an increased focus on interpersonal and inter-professional engagement and interaction across workforce and service users.

Design/methodology/approach

The project involved a literature review which identified themes that were in turn used to inform an approach to a desk review of journal articles written about past integration programmes in healthcare. A coding framework was developed to assess the articles in the desk review to identify where the focus of attention lay in the approaches to integration.

Findings

There is a spread of activity across all four themes (leadership, strategy, structure and people) in the assessed cases, but the emphasis tends to be towards static, short-term approaches, with a noticeable lack of focus on the aspects required to deliver long-term sustained transformation. There is a need for improved balance between structural and relational approaches to transformation.

Research limitations/implications

The paper focuses on nine examples of transformation programmes and would benefit from further development and use of the coding framework.

Practical implications

The framework that emerges from this project can contribute to the development of a proactive model to assist transformation leads and decision makers bring a more balanced, thoughtful and impactful approach to integrating health and care services. In particular, the findings point to an overuse of structural approaches to change and transformation, which could include project management methods, for example, which become the product of the initiatives, rather than enablers of leaders’ visions and people’s interpersonal and interprofessional engagement and interactions.

Originality/value

Building on existing research, this paper makes a valuable contribution to the discourse on how to deliver the required health and care integration agenda in a more accessible way and sustainably, moving away from short-term, quick-fix approaches and considers how to accommodate the role of interpersonal interaction as the vehicle for change.

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