Health Equity: 10/06/08

Monday, October 6, 2008

[EQ] A model and typology of collaboration between professionals in healthcare organizations

A model and typology of collaboration between professionals in healthcare organizations

Danielle D’Amour1, Lise Goulet 2, Jean-François Labadie 3, Leticia San Martín-Rodriguez 4, Raynald Pineault 5

1 Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada

2 Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada

3 Centre de santé et de services sociaux de Bordeaux-Cartierville-Saint-Laurent, Quebec, Canada

4 University Hospital of Navarra, University of Navarra, Pamplona, Spain

5 Public Health Directorate, Montreal, Quebec, Canada

BMC Health Services Research – 22 September 2008, 8:188doi:10.1186/1472-6963-8-188

Available online as PDF file [38p.] at: http://www.biomedcentral.com/content/pdf/1472-6963-8-188.pdf

Background

The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec.
The objectives are to:
1) validate the indicators of the structuration model of collaboration;
2) evaluate interprofessional and interorganizational collaboration in the four health regions; and
3) propose a typology of collaboration

Methods

A multiple-case research strategy was used. The cases were the healthcare facilities that offer perinatal services in four health regions in the province of Quebec (Canada). The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions. Written material was also analyzed. The data were subjected to a "mixed" inductive-deductive analysis conducted in two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases.

Results

The collaboration indicators were shown to be valid, although some changes were made to three of them. Analysis of the data showed great variation in the level of collaboration between the cases and on each dimension. The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.

Conclusions

The model and the typology make it possible to analyze collaboration and identify areas for improvement. Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes. Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.

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[EQ] EU law and health policy in Europe

EU law and health policy in Europe

Julia Lear and EliasMossialos

The Health Policy Bulletin of the European Observatory on Health Systems and Policies
Volume 10, Number 3 - 2008

Available online PDF [12p.] at: http://www.euro.who.int/Document/OBS/EuroObserver_Autumn2008.pdf

“”…..Although Member States retain the primary responsibility for organization and delivery of health services under Article 152 of the EC Treaty, this policy space is still shaped by Community law and policy. The Community did not have legal authority in the field of public health until 1999, when the public health article was amended and renumbered by the Treaty of Amsterdam as the current Article 152. Treaty Article 152 defines the role of the EU as complementing national policies, sets out procedures by which the EU institutions may act in the health field, and delineates the types of measures that may be enacted, but explicitly bars the use of harmonization. Thus, the EU is limited to establishing public health programmes and incentives for preferred health policies.

Although the EU has no formal legal powers to enact Community health care legislation, several different policy domains influence health policy, including principally: internal market, social affairs, public health, enterprise and economic policy. This diffusion of health care governance raises several complications. Without direct authority, there is no clear hierarchy for health policy decision-making. There are also the twin problems of accountability and transparency. Without a unified body of health legislation, independent bodies attempting to monitor, analyze, and report on the effectiveness of EU health policies must assemble a diverse body of legal documents and chase after a dispersed group of officials.

Similarly, determining the scope of Europeans’ rights to health care requires a search through the Treaty, the European Convention on Human Rights, the European Social Charter, as well as a number of conventions governing everything from food safety to privacy to environmental protection….

Contents

- EU law and health policy in Europe

- Public procurement and State aids in public health care systems

- Competition law and health services

- Internal market rules and regulation of private health insurance: threat or opportunity?

- The European pharmaceutical market: An expanding tool kit?

- Cross-border services

The Observatory is a partnership between the WHO Regional Office for Europe, the Governments of Belgium, Finland, Greece, Norway, Spain, Slovenia and Sweden, the Veneto Region of Italy, the European Investment Bank, Open Society Institute, the London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine.

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