Network resilience in the face of health system reform
Many health systems now use networks as governance structures. Network 'macroculture' is the complex of artefacts, espoused values and unarticulated assumptions through which network members coordinate network activities. Knowledge of how network macroculture during 2006-2008 develops is therefore of value for understanding how health networks operate, how health system reforms affect them, and how networks function (and can be used) as governance structures. To examine how quasi-market reforms impact upon health networks' macrocultures we systematically compared longitudinal case studies of these impacts across two care networks, a programme network and a user-experience network in the English NHS. We conducted interviews with key informants, focus groups, non-participant observations of meetings and analyses of key documents. We found that in these networks, artefacts adapted to health system reform faster than espoused values did, and the latter adapted faster than basic underlying assumptions. These findings contribute to knowledge by providing empirical support for theories which hold that changes in networks' core practical activity are what stimulate changes in other aspects of network macroculture. The most powerful way of using network macroculture to manage the formation and operation of health networks therefore appears to be by focusing managerial activity on the ways in which networks produce their core artefacts.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 70 (2010)
Issue (Month): 5 (March)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Granovetter, Mark, 1995. "Coase Revisited: Business Groups in the Modern Economy," Industrial and Corporate Change, Oxford University Press, vol. 4(1), pages 93-130.
- Hillebrand, Bas & Biemans, Wim G., 2003. "The relationship between internal and external cooperation: literature review and propositions," Journal of Business Research, Elsevier, vol. 56(9), pages 735-743, September.
- Lewis, Jenny M. & Baeza, Juan I. & Alexander, Damon, 2008. "Partnerships in primary care in Australia: Network structure, dynamics and sustainability," Social Science & Medicine, Elsevier, vol. 67(2), pages 280-291, July.
- repec:dau:papers:123456789/1219 is not listed on IDEAS
- Sylvie Ehlinger & Véronique Perret & Didier Chabaud, 2007. "Quelle gouvernance pour les réseaux territorialisés d'organisations ?," Post-Print halshs-00536280, HAL.
- Cott, Cheryl, 1997. ""We decide, you carry it out": A social network analysis of multidisciplinary long-term care teams," Social Science & Medicine, Elsevier, vol. 45(9), pages 1411-1421, November.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:70:y:2010:i:5:p:779-786. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If references are entirely missing, you can add them using this form.