Integrated care as an organisational challenge: an exploratory case study (poster presentation)

Introduction: Integrated care is aimed towards more demand-driven and cost-conscious health systems. The multidisciplinary research project CORTEXS brings together expertise on organization sciences and integrated care [1]. Aims: In order to gain a better grasp of the connection of the concept of integrated care with principles of organisational design, we conducted an exploratory case study on task division and allocation in a regional hospital [2]. Case study: The study is specifically focused on the integration of previously autonomous geriatric departments in a regional hospital. Given the issue of undernourishment with geriatric patients, we describe the complex whole of nourishment-related activities, which need to be geared to one another. The paper analyses the organisational changes that were implemented in order to allow for a more intensive collaboration and for a higher level of staff commitment. The introduction of multidisciplinary teams, decentralisation of decision making, and participatory change proved to be essential. Data was collected through multiple focus group sessions with senior and middle management, health care workers, and support staff. Conclusions: The case study results show that the level of care fragmentation is closely linked to the underlying organisational model. Classical bureaucratic recipes of scaling up and specialisation may lead to lower levels of collaboration and commitment. Integrated care may therefore benefit from the adoption of workplace innovation principles [3], which are specifically aimed at simultaneously improving organisational performance and the quality of jobs on a sustainable basis. The paper ends with the presentation of some striking examples from previous research, indicating that, although context and boundary conditions may differ, the organisational challenges which the health care sector is currently facing, may not be unique to the health care domain. 1. Dessers E, Dhondt S, Vrijhoef H, Molema J, Van Hootegem G, Nys H, Hermans K, Hellings J, Cambré B, Annemans L. A multidisciplinary and multi-method research framework for studying integrated care in Flanders (Belgium). World Congress on Integrated Care. Singapore, 7-9 November 2013. 2. Corvers B, Van Hootegem G. Slimmer zorgen voor morgen. Het nieuwe organiseren in theorie en praktijk. [Smarter Care for Tomorrow. New Organising in Theory and Practice.] To be published; 2013. [in dutch]. 3. Pot F. Workplace innovation for better jobs and performance. International Journal of Productivity and Performance Management 2011;60(4):404-415.status: publishe