Exploiting Inter-Organizational Relationships in Health Care: A Bibliometric Analysis and Literature Review

Reasons for merging and collaborating in healthcare: Marriage or living apart together?

BACKGROUND

Across OECD countries, integration between healthcare organisations has become an indispensable part of contemporary healthcare provision. In recent years, inter-organisational collaboration has increasingly been encouraged in health and competition policy at the expense of mergers. Yet, understanding of whether healthcare organisations make an active choice between merging and collaborating is lacking. Hence, this study systematically examines (i) healthcare executives' motives for integration, (ii) their potential trade-offs between collaborating or merging, and (iii) the barriers to collaborating perceived by them.

METHODS

Early 2019, an online questionnaire was conducted among a nationwide panel of 714 healthcare executives in the Netherlands. Because of their strategic position within healthcare organisations as end-responsible managers, healthcare executives are especially suited to provide broad and in-depth knowledge on the internal and external processes and decisions. Three hundred thirty-seven Dutch healthcare executives completed the questionnaire (response rate 47%). This study sample was representative of the largest healthcare sectors in the Netherlands. In total, 137 mergers and 235 inter-organisational collaborations were reported. Both closed questions and open-ended questions were systematically analysed.

RESULTS

Improving or broadening healthcare provision is the foremost motive for mergers as well as inter-organisational collaborations. When considering both types, reducing governance complexity is one of the decisive reasons to opt for a merger, whereas aversion towards a full merger and lack of support base within the own organisation convinced healthcare executives to choose for a collaboration. When comparing specific healthcare sectors, the overlap in pursued motives and sub-motives indicates that inter-organisational collaborations and mergers are used for comparable objectives. Only a small minority of the responding executives switched between both types of integration. Institutional barriers, such as laws, regulations and financing regimes, appear to be the most restricting for healthcare executives to engage in inter-organisational collaborations.

CONCLUSIONS

Our integral approach and systematic comparison across sectors could serve policymakers, regulators and healthcare providers in aligning organisational objectives and societal objectives in decision-making on collaborations and mergers. Future research is recommended to study multiple collaboration and merger cases qualitatively for a detailed examination of decision-making by healthcare executives, and develop an integral assessment framework for balancing collaborations and mergers based on their effects in the medium to long term.

Designing for Resilience: How Dutch Maternity Care Collaborations Anticipate, Adapt, and Thrive during a Pandemic

The success factors and challenges of interorganizational collaboration have been widely studied from different disciplinary perspectives. However, the role of design in making such collaborations resilient has received little attention, although deliberately designing for resilience is likely to be vital to the success of any interorganizational collaboration. This study explores the resilience of interorganizational collaboration by means of a comparative case study of Dutch maternity care providers, which have been facing major challenges due to financial cutbacks, government-enforced collaborative structures, and the recent COVID-19 pandemic. Our findings make two contributions to the literature. First, we further develop the construct of interorganizational resilience. Second, we shed light on how well-designed distributed decision-making enhances resilience, thereby making a first attempt at meeting the challenge of designing for interorganizational resilience.

Reaping the benefits of digital transformation through Public-Private Partnership: A service ecosystem view applied to healthcare

The ongoing digital transformation ushers unprecedented challenges for publicly owned healthcare organizations. Collaborative governance models, such as Public Private Partnerships (PPPs), advance their readiness to address such challenges, paving the way for the establishment of a viable service ecosystem. However, little is known about how PPPs enhance the publicly owned healthcare organizations’ ability to thrive amidst the digital transformation. The article investigates this issue, drawing on the exploratory case of “Lab@AOR”, a PPP established between Loccioni and the University Hospital of Marche (Italy) which focused on the robotization of a critical component of healthcare services’ delivery. Three ingredients have been found to nurture the PPP’s cohesiveness and success: (1) the alignment between the public partner’s needs and the private partner’s competences, (2) knowledge contamination, and (3) the adoption of patient-centeredness as the inspiring principle of the collaboration. The PPP represents an initial step of the transition towards a service ecosystem, entailing a fully-fledged partners’ integration for value co-generation.

Collaborative care: Primary health workforce and service delivery in Western New South Wales-A case study

OBJECTIVE

To explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework.

DESIGN

Descriptive case study approach.

SETTING

The collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non-governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion.

PARTICIPANTS

Stakeholders of the collaborative design including organisations and the community.

INTERVENTION

A place-based approach to co-designing health services with community in one sub-region of Western New South Wales.

MAIN OUTCOME MEASURES

A synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework.

RESULTS

The collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town-based planning.

CONCLUSION

This study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability.