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Critical issues for employees in inter-municipal health care services: a multiple case study

BACKGROUND: Traditional, hierarchical government structures have recently been challenged by increased complexity, fragmented services and heavy public demand. When healthcare services become fragmented and decentralised, they require redesign. Inter-municipal cooperation is a strategy to deal with...

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Autores principales: Holen-Rabbersvik, Elisabeth, Eikebrokk, Tom Roar, Fensli, Rune Werner, Thygesen, Elin, Slettebø, Åshild
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196433/
https://www.ncbi.nlm.nih.gov/pubmed/30348149
http://dx.doi.org/10.1186/s12913-018-3586-8
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author Holen-Rabbersvik, Elisabeth
Eikebrokk, Tom Roar
Fensli, Rune Werner
Thygesen, Elin
Slettebø, Åshild
author_facet Holen-Rabbersvik, Elisabeth
Eikebrokk, Tom Roar
Fensli, Rune Werner
Thygesen, Elin
Slettebø, Åshild
author_sort Holen-Rabbersvik, Elisabeth
collection PubMed
description BACKGROUND: Traditional, hierarchical government structures have recently been challenged by increased complexity, fragmented services and heavy public demand. When healthcare services become fragmented and decentralised, they require redesign. Inter-municipal cooperation is a strategy to deal with current challenges and future demographic changes. Few studies exist that can help us conceptualize challenges regarding employment in this context and inform managers in the involved municipalities. This study aims to identify critical issues for employees in inter-municipal health care services and to elaborate on how and why these issues are experienced. METHODS: A multiple qualitative case study was conducted with data from interviews, observation studies, a participant workshop and inter-municipal healthcare service project documents and reports. The study involved two districts in Norway and six cases including 17 informants. First, a within-case analysis was conducted for all cases; second, a cross-case analysis was conducted in each district to examine replication, contrasts and extension to emergent findings; and, eventually, replicated findings in Districts 1 and 2 were analysed across districts. RESULTS: Three critical issues were identified: support, differences, and geographical distances. Employees working in teams experienced fewer challenges than did those working as isolated individuals. CONCLUSIONS: Critical issues for employees represent an important aspect of inter-municipal cooperation, and additional research should be undertaken to inform future policy and practice.
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spelling pubmed-61964332018-10-30 Critical issues for employees in inter-municipal health care services: a multiple case study Holen-Rabbersvik, Elisabeth Eikebrokk, Tom Roar Fensli, Rune Werner Thygesen, Elin Slettebø, Åshild BMC Health Serv Res Research Article BACKGROUND: Traditional, hierarchical government structures have recently been challenged by increased complexity, fragmented services and heavy public demand. When healthcare services become fragmented and decentralised, they require redesign. Inter-municipal cooperation is a strategy to deal with current challenges and future demographic changes. Few studies exist that can help us conceptualize challenges regarding employment in this context and inform managers in the involved municipalities. This study aims to identify critical issues for employees in inter-municipal health care services and to elaborate on how and why these issues are experienced. METHODS: A multiple qualitative case study was conducted with data from interviews, observation studies, a participant workshop and inter-municipal healthcare service project documents and reports. The study involved two districts in Norway and six cases including 17 informants. First, a within-case analysis was conducted for all cases; second, a cross-case analysis was conducted in each district to examine replication, contrasts and extension to emergent findings; and, eventually, replicated findings in Districts 1 and 2 were analysed across districts. RESULTS: Three critical issues were identified: support, differences, and geographical distances. Employees working in teams experienced fewer challenges than did those working as isolated individuals. CONCLUSIONS: Critical issues for employees represent an important aspect of inter-municipal cooperation, and additional research should be undertaken to inform future policy and practice. BioMed Central 2018-10-22 /pmc/articles/PMC6196433/ /pubmed/30348149 http://dx.doi.org/10.1186/s12913-018-3586-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Holen-Rabbersvik, Elisabeth
Eikebrokk, Tom Roar
Fensli, Rune Werner
Thygesen, Elin
Slettebø, Åshild
Critical issues for employees in inter-municipal health care services: a multiple case study
title Critical issues for employees in inter-municipal health care services: a multiple case study
title_full Critical issues for employees in inter-municipal health care services: a multiple case study
title_fullStr Critical issues for employees in inter-municipal health care services: a multiple case study
title_full_unstemmed Critical issues for employees in inter-municipal health care services: a multiple case study
title_short Critical issues for employees in inter-municipal health care services: a multiple case study
title_sort critical issues for employees in inter-municipal health care services: a multiple case study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196433/
https://www.ncbi.nlm.nih.gov/pubmed/30348149
http://dx.doi.org/10.1186/s12913-018-3586-8
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