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The challenges of collaborating in an integrated health care system

For many years it has been pointed out by users, next-of-kin, professionals and the authorities that treatment should be better coordinated for those who need help from several health services. It is known that failure often arises in the transition between different services, institutions and units. The main objective of this project is to obtain knowledge on how one can achieve comprehensive health care for users in need of coordinated services.

The challenges of collaborating in an integrated health care system
The challenges of collaborating in an integrated health care system. Ill.:

Through observations and interviews we will explore:

  1. the mechanisms behind cooperation and
  2. the assessments made by patients and service deliverers regarding how services are coordinated and what conditions promotes and prevents cooperation.

We will focus on the impact the differences in knowledge base and the differences in understanding of each other's tasks and roles have on cooperation between the different health professionals and how they are manifested in practice.

We have chosen a multi-site study design where we will examine collaboration from different angles in four sub-projects with different contexts:

  1. Mental health care
  2. Specialized short-term unit
  3. Home-based rehabilitation
  4. Collaboration between family doctors and the other municipal helpers.

The objective of sub-project 1 is to find out how continuity and connection, or discontinuity, in available services, functions in practice, and how these services are experienced from the perspective of users of mental health services. Through interviews with nine young service users four times during one year we have explored the users’ experiences with the coordinating of the services and the collaboration between the providers. The informants tell about considerable discontinuity in the services.

In sub-project 2 we the aim is exploring experiences with a short-term ward for patients 60 years and older in their transition from hospital to home from different perspectives: the patients and their relatives; the health care providers within the ward; providers at the hospital; and the providers of long-term care in the municipality. The results indicate that challenges in collaboration occur when a new unit is established in an existing healthcare system.

In sub-project 3 the aim is to explore how rehabilitation should be organized and carried out in first line health services. The results show that there is a discrepancy between the high level of ambition of the health authorities and the possibilities the practitioners have of realising them.

In the fourth sub-project we want to draw attention to possibilities and conditions for collaboration, and factors that promote or inhibit this collaboration, primarily focusing on the collaboration between family doctors and other bodies in the first-line services. It seems to be better collaboration between the health personal in the municipality and their colleagues in the hospital than between the health personal in different departments in the municipality.

The project is implemented in cooperation with:

  • Forskningssenteret, Akershus universitetssykehus
  • University of York
  • Dept. of Behavioural Sciences in Medicine, Universitety of Oslo

Key Factors

Project duration

01/01/2010 - 31/12/2013