Journal of Occupational Rehabilitation, 2005; 15(4): 581–90. DOI: https://doi.org/10.5334/ijic.3068.s1. This first search produced a total of 914 potentially relevant hits. Task-shifting between different categories of health professionals, for instance between general practitioners and nurse practitioners, could also cause friction. They are not only context-specific, but are also often related and influence each other. When inter-organisational collaboration stretches over a wider geographical distance, “differences in the meaning and use of relevant concepts between countries and regions” [53, p. 950] may also occur. Around 75% of healthcare spending in Europe is directed towards managing and treating chronic diseases. Wicked problems, knowledge challenges, and collaborative capacity builders in network settings. The barriers approach to innovation. Like any review, this analysis has limitations. DOI: https://doi.org/10.1007/s10926-009-9205-0, Loisel, P, Durand, MJ, Baril, R, Gervais, J and Falardeau, M. Interorganizational collaboration in occupational rehabilitation: Perceptions of an interdisciplinary rehabilitation team. But is there proof of this, and which model works best, given that there are so many different pilots in operation? “Barriers to the Integration of Care in Inter-organisational Settings: A Literature Review”. Social Science and Medicine, 2006; 63(12): 3199–211. Because these categories serve mainly an analytical purpose, it is likely that the kinds of barriers and their domain of occurrence overlap (for instance, bad collaboration experiences can affect individuals entrusted with service delivery as well as organisations). DOI: https://doi.org/10.1080/1356182021000044166, McGuire, M and Agranoff, R. The limitations of public management networks. Hopefully, however, these findings will give new input to research and can help healthcare professionals, managers, teachers and policy makers to identify, avoid and overcome barriers to integrated care in inter-organisational settings. Having the right financial incentives in place is in other words a crucial factor to making integrated care work. Missing actors: The lack of important actors can be a barrier to successful collaboration in a certain nexus of health service delivery [12]. 2018. They can take on – following the integration needs of care – several directions: vertical collaboration along the chain of health service delivery, including, for instance, collaboration between providers of primary and secondary care, or horizontal collaboration between organisations of the same kind, e.g. due to the research question) or unintentionally (e.g. The end goal is to provide higher quality care, resulting in better health outcomes for the patient, and a better patient experience of the care journey, often at the same or even lower cost. For instance, if a (mandated) collaboration threatens the political and economic interests of an organisation involved, it can be very reluctant to collaborate [62]. This approach enables a systematic review, although the analysis underlies some restrictions: monographs or chapters in edited volumes were intentionally omitted, as they are not listed systematically in data bases and may show quality constraints due to a lack of peer-review. The study examined co-occurring disorder service delivery for mental health clients in Los Angeles County, California. Organization Science, 2011; 22(4): 940–60. Our instincts tell us that integrated care, if functioning well, should provide better quality care for patients more efficiently. More often than not, the integration of care faces barriers [8–11] caused by contextual, institutional and professional factors in different domains of integrated care [1]. Typically, organisations calculate and pursue their own interests versus the collaborative interest. an organisation that fears a loss of autonomy caused by collaboration). International Journal of Integrated Care, 2008; 8(6): 1–12. with regard to the number and type of collaboration partners, the content and goal of collaborations and the national context), the comparability of the barriers arising in these inter-organisational collaborations underlies limitations. The author thanks the two anonymous reviewers of IJIC, Joerg Sydow, two anonymous reviewers and participants of the AOM 2016 meeting (5th–9th August 2016 in Anaheim), as well as participants of the EGOS 2016 sub-theme 52 (7th–9th July 2016 in Naples) for their very helpful comments on earlier versions of this paper. The key barriers to patient and family centred care were: i) staffing constraints and reduced levels of staff experience, ii) high staff workloads and time pressures, iii) physical resource and environment constraints and iv) unsupportive staff attitudes. A further example of institutional arrangements that cause barriers to emerge passively is the professionalisation of different occupational groups with strong identities, which do not necessarily support the inter-professional collaboration that is often asked for when practicing inter-organisational collaboration in healthcare [48]. Lack of technological standards: Especially inter-organisational collaboration that requires the use of common IT-infrastructure faces formidable challenges with regard to lacking interoperability. The case study concluded that although major progress had been made, there were still barriers to a fully-functioning, integrated care system. The barriers identified in this literature review can be grouped into six main categories that stretch across different domains (see Figure 2). The issue of barriers that impede inter-organisational collaboration in health service delivery has been addressed in the selected sample of articles in both an empirical (35 studies) and a conceptual way (5 studies, three of them literature reviews, however with the main focus not being on barriers to inter-organisational collaboration). DOI: https://doi.org/10.1111/cch.12322, Dinesen, B, Seeman, J and Gustafsson, J. Health Services Research, 2014; 49(6): 1883–99. Another is that behavioral health and primary care are entirely different care models. Journal of Health Organization and Management, 2010; 24(2): 200–17. Managing inter-organizational relations: Debates and cases. International Journal of Integrated Care, 2014; 14(4): 1–2. of patient data) needed to enable planned inter-organisational collaboration, or they can provide obstacles to the pooling of budgets in the public sector [8, 55]. talks with experts. In care organisations all over Europe, and the world, great work is being done in experimenting with new, innovative models that can solve these issues. It analyses how these barriers operate. The author has no competing interests to declare. Key barriers to access for CBTp identified in this study comprise of, little or no access to CBTp, lack of integration of services and unclear referral pathways. Flow chart of the identification and selection process. Others point to regulative constraints that many actors have already experienced while experimenting with collaboration [21]. The reviewed literature provides insights on the relationships between barriers as well as their causes. DOI: https://doi.org/10.1016/B978-008044198-6/50038-3, Sun, X, Tang, W, Ye, T, Zhang, Y, Bo, W and Zhang, L. Integrated care: A comprehensive bibliometric analysis and literature review. An exploratory study of conflict and its management in systems of care for children with mental, emotional, or behavioral problems and their families. 24] as parts of the context influence the existence of barriers and vice versa. Fourth, probably more barriers exist than those captured by the papers reviewed here. Additionally, the review only includes the results of the reviewed studies, which could limit its scope (e.g. its specific governance mechanisms such as, e.g. In their study Tsasis and colleagues report on a healthcare professional who states that he does not necessarily understand exactly how other organisations in the same community contribute to the care of clients. This discussion paper expands on three of the recommendations from a paper commissione… While reviewing the literature, it became clear that barriers can, on the one hand, be raised and actively and purposefully promoted by certain individual and organisational actors. The constitution of society: Outline of the theory of structuration. Objectives: The goal of this study was to assess pediatric oncology providers' perceptions of palliative care in order to validate previously identified barriers and facilitators to early integration of a pediatric palliative care team (PCT) in the care of children with cancer. Hardy, B, Mur-Veemanu, I, Steenbergen, M and Wistow, G. Inter-agency services in England and The Netherlands. Health Care Management Review, 1995; 20(1): 54–64. The articles were first coded line by line with rather descriptive codes, representing barriers that occurred. Langley, A. Regarding inter-organisational collaborations, some regions seem to use cooperation practices more than others (e.g. DOI: https://doi.org/10.1111/j.1467-9299.2011.01917.x, McPherson, C, Ploeg, J, Edwards, N, Ciliska, D and Sword, W. A catalyst for system change: A case study of child health network formation, evolution and sustainability in Canada. For instance, the particular design of a national health system (e.g. In a third step, all the remaining articles were read in depth in order to determine whether they were suited to explain the occurrence of barriers that impede the integration of care in inter-organisational settings. good vs. poor management) can facilitate an implementation process [10, 12]. International Journal of Integrated Care, 2016; 16(1): 1–18. To increase the consistency and robustness of the findings, monographs [20] and edited volumes [32], with a similar focus and which were mentioned in the articles, were also surveyed. DOI: http://doi.org/10.5334/ijic.3068, Auschra, C. (2018). DOI: https://doi.org/10.5334/ijic.511, Sydow, J, Schreyögg, G and Koch, J. Therefore, this domain touches a more micro, individual level of analysis. reciprocity between autonomous organisations. Some scholars argue that a lack of common goals or leadership inhibits collaboration [20]. Health Policy, 2003; 65(2): 139–51. DOI: https://doi.org/10.1111/j.1447-0748.2005.00198.x, Hosman, CMH. 5. International Journal of Integrated Care, vol. Hall, P. Interprofessional teamwork: Professional cultures as barriers. The shared leadership challenge in strategic alliances: Lessons from the U.S. healthcare industry. International Journal of Integrated Care. DOI: https://doi.org/10.1287/orsc.1100.0578, Doz, YL. According to Kodner and Spreeuwenberg, this domain includes governmental regulations and administrative functions. Organisational vs. collective interests: Within inter-organisational collaboration, different organisations with divergent goals and interests work together. Inter-organisational collaborations in healthcare appear in several forms, e.g. DOI: https://doi.org/10.1016/S0168-8510(99)00037-8, https://doi.org/10.1016/S0168-8510(02)00205-1, https://doi.org/10.1097/00004010-199502010-00007, https://doi.org/10.1007/978-1-137-37003-7, https://doi.org/10.1097/00004010-200201000-00003, https://doi.org/10.1007/s10926-010-9281-1, https://doi.org/10.1097/HMR.0b013e31822aa443, https://doi.org/10.1080/13561820500081745, https://doi.org/10.1093/oxfordhb/9780199282944.001.0001, https://doi.org/10.1111/j.1540-6210.2007.00866.x, https://doi.org/10.1007/s11301-014-0109-5, https://doi.org/10.1016/B978-008044198-6/50038-3, https://doi.org/10.1016/j.jclinepi.2009.06.005, https://doi.org/10.1007/s11414-014-9448-1, https://doi.org/10.1080/13561820902921811, https://doi.org/10.1016/j.socscimed.2006.07.031, https://doi.org/10.1108/14777261011047354, https://doi.org/10.1111/j.1447-0748.2005.00198.x, https://doi.org/10.1016/S0306-4603(00)00127-1, https://doi.org/10.1080/1356182021000044166, https://doi.org/10.1111/j.1467-9299.2011.01917.x, https://doi.org/10.1186/s12913-017-2018-5, https://doi.org/10.1111/j.1540-6210.2012.02595.x, https://doi.org/10.1007/s10926-009-9205-0, https://doi.org/10.1007/s10926-005-8036-x, https://doi.org/10.1186/s12884-017-1381-x, https://doi.org/10.5465/AMR.2009.44885978, https://doi.org/10.1177/003803857200600101. Further attention is called for to barriers to the integration of care in inter-organisational settings, as there is a significant gap between what “could” be possible in collaborative practice and what actually is achieved within most inter-organisational relationships. However, this interpretation may well underlie a bias, as we do not know if the reviewed studies illustrate all existing barriers that hampered a collaboration or if researchers maybe also intentionally (e.g. 71]: although the relationships between barriers were analysed systematically, no consistent patterns were identifiable. Several empirical works address barriers to the delivery of integrated care in inter-organisational settings, but mostly focus on aspects specific to their case [11, 27] and lack theoretical embedding. Building bridges, breaking barriers looks at how well care for older people is integrated across health and social care, as well as the impact on older people who use services and their families and carers. The management of chronic diseases poses specific challenges to healthcare systems. Management Review Quarterly, 2015; 65(2): 113–48. Inter-organisational collaborations – as opposed to market or hierarchical relationships – feature certain characteristics: firstly, partners within the inter-organisational relationship follow either a common goal or purpose [20, 23]. Fourthly, the partners follow certain rules, norms, and structures within the relationship – rendering the relationship either formal or informal [34]. due to certain institutionalized structures [cf. DOI: https://doi.org/10.1177/0004867414541683, Cooper, M, Evans, Y and Pybis, J. Interagency collaboration in children and young people’s mental health: A systematic review of outcomes, facilitating factors and inhibiting factors. Los Angeles, CA: Sage; 2014. However, such a view contains pitfalls, as the mere elimination of the factor that causes a barrier does not guarantee that a practice hindered by this barrier will take place. It is important to note that barriers do indeed represent obstacles, but obstacles which can be overcome, often in a gradual, processual way. With coordinated approaches requiring the involvement of services … Often, additional facilitators are necessary to enable, for instance, the successful integration of care. Beneficial practices of inter-organisational collaboration that help to integrate care include, for instance, the mutual exchange and transfer of information and knowledge, enhanced trust between providers, and the creation of synergy effects [13, 14]. Related barriers of this kind can also be found on other levels of analysis, and can be driven both by agents and/or structure. Organizational structure, environment and performance: The role of strategic choice. So just as important as having interconnected Health IT systems, is the capability of the same systems to collect data on health outcomes that both matters to patients and are comparable from one database to another. Journal of Interprofessional Care, 2005; 19(S1): 188–96. The consideration of different levels is useful as conflicts on the level of service delivery, for example, can also influence collaboration on the inter-organisational level [52], and vice versa. This review focuses on academic peer-reviewed articles in English-language journals that were retrieved from the databases PubMed (https://www.ncbi.nlm.nih.gov/pubmed); Cochrane Library (http://www.cochranelibrary.com/); Web of Science (https://apps.webofknowledge.com); and via the resource hoster EBSCOhost (https://www.ebscohost.com/) Business Source Premier, Communication Source, EconLit, ERIC, MEDLINE, PsycARTICLES, PsycCRITICS, SocINDEX, and Academic Search Ultimate. book chapters, monographs), thereby also omitting further barriers. DOI: https://doi.org/10.1002/hpm.826. of the collaboration itself, within its context) and of the actions of the collaborating partners [37]. Alliances in health care: What we know, what we think we know, and what we should know. Financial barriers: costs associated with development, implementation and optimization of health IT to comply with health care program requirements that change frequently. Taking part in an inter-organisational collaboration also implies a loss of organisational autonomy, e.g. DOI: https://doi.org/10.1093/heapro/18.2.135, Dinesen, B, Gustafsson, J, Nøhr, C, Andersen, SK, Sejersen, H and Toft, E. Telehomecare technology across sectors: Claims of jurisdiction and emerging controversies. This discussion paper focuses on some particularly challenging aspects of bridging primary care and oral health care for low health literacy populations. that the absence of a barrier or its opposite (e.g. These differing backgrounds of healthcare employees can hamper inter-organisational collaboration [27, 66]. 39, 40]. more actively raised barriers) and structure (more passively induced barriers) are recursively related to each other, mutually (re-) producing and transforming each other [37]. International Journal of Integrated Care. On the other hand, barriers can also emerge more passively behind the back of actors, e.g. This is often exacerbated by a lack of clarity about roles and responsibilities, poor or inconsistent communication, and heavy reliance on the professional relationship between two individuals rather than between services … Thus, the analysis of barriers to inter-organisational collaboration may benefit from a clear distinction between the organisational and inter-organisational domain. DOI: https://doi.org/10.1089/pop.2016.0036, Shortell, SM, Wu, FM, Lewis, VA, Colla, CH and Fisher, ES. DOI: https://doi.org/10.5334/ijic.843, Pate, J, Fischbacher, M and Mackinnon, J. Ring, PS and Van de Ven, AH. in regard to specialization and ideology, may be difficult [54]. Academy of Management Executive, 2001; 15(2): 71–9. Johnson and colleagues [56] actually observed that organisational actors used complicated planning processes to delay joint working. when they referred only to barriers to the interoperability of IT systems or IT-networks. DOI: https://doi.org/10.1007/s10926-010-9281-1, Majchrzak, A, Jarvenpaa, SL and Bagherzadeh, M. A review of interorganizational collaboration dynamics. Fleury, M-J, Perreault, M, Grenier, G, Imboua, A and Brochu, S. Implementing key strategies for successful network integration in the Quebec substance-use disorders programme. Such a focus is especially important, as some barriers occurring during inter-organisational collaboration are particular to this governance form due to the existence of the inter-organisational domain, where, for instance, formally autonomous and culturally different organisations collaborate. [1] These patients are to a large extent elderly people with multiple chronic conditions. Second, the review illustrates that these barriers can either be actively raised by certain actors, or emerge more passively due to structural and institutional arrangements. Organisational goals do not need to overlap with collective goals [28]. Confidentiality issues: Previous studies have reported that confidentiality issues can impede inter-organisational collaboration, e.g. Journal of Behavioral Health Services & Research, 2015; 42(3): 310–23. Despite the need for holistic approaches to complex problems, there are several practical barriers that prevent effective care coordination between services. no effect on the collaboration, its transformation or even its termination. DOI: https://doi.org/10.1186/s12884-017-1381-x. Jannie Kristine Bang Christensen, Postdoctoral researcher/assistant professor, PhD, Department of Sociology and Social Work, Center of Organization, Management, and Administration (COMA), Aalborg University, Denmark. National borders: Borders of neighbouring territories can work as barriers to the integration of care in inter-organisational settings, especially by causing administrative or regulatory differences due to different healthcare systems and languages [49]. Cultural differences between organisations can affect various areas that are relevant for inter-organisational collaboration, e.g. Introduction: In recent years, inter-organisational collaboration between healthcare organisations has become of increasingly vital importance in order to improve the integration of health service delivery. In primary healthcare, a key barrier to effective and timely care was the lack of availability of general practice-based spirometry together with appropriate use of spirometry by general practitioners (GPs) and practice nurses to both diagnose and manage a patient with COPD: The theory and practice of collaborative advantage. Health Policy, 1999; 48(2): 87–105. However, the current studies included in the review (giving, for instance, little evidence on barriers in Asia, Africa, and South America as also relevant national contexts or characteristic traits of individuals) and the compilation of the types of barriers does not allow reliable conclusions on certain contingent patterns of contextual influence. For instance, the same barrier may have a different effect at different stages of a collaboration (initiation, development, maturing), e.g. In: Cropper, S, Ebers, M, Huxham, C and Ring, PS (eds. Journal of Management Studies, 2003; 40(2): 321–47. DOI: https://doi.org/10.1097/00004010-200201000-00003, Pimperl, A, Schulte, T, Muhlbacher, A, Rosenmoller, M, Busse, R, Groene, O, et al. Within the reviewed studies, different types of barriers are mentioned (for an overview see Figure 2). The additional file for this article can be found as follows: Tables 1 and 2. Hueske, A-K and Guenther, E. What hampers innovation? Historical developments: Historical developments and critical junctures, often on the macro level, influence the behaviour of organisational and individual actors. A comparative study of integrated care development and delivery. International Journal of Integrated Care 18 (1): 5. Duplicates in the identified records were removed; 729 articles then remained. This helps to explain why some inter-organisational collaborations that aim for the integration of care make slow or no progress. Developmental processes of cooperative interorganizational relationships. This paper, based on a systematic review of the literature, puts an emphasis on barriers to the integration of care in inter-organisational settings as one of the governance They have gathered experiences from former collaborations, it became clear that the notion of barriers. Challenges with regard to lacking interoperability [ 48, 51, 67 ] promotion international 2003! ; 58 ( 2 ): 1–3 barriers can also emerge more passively behind the back of actors e.g! Care 18 ( 1 ): 1–17 reported that confidentiality issues can inter-organisational. Handbook on innovation, 2003 ; 65 ( 2 ) Goldman, HH 56 ] actually that. Argue that a main concern of the stakeholders involved in the theory of structuration to a lack organisational. Within a single organisation such as a symptom of one or more underlying causes that constitute barrier!, different professions underlie divergent cultural assumptions, professional values and follow different procedures research on the relationships between as..., 2010 ; 20 ( 3 ): 139–51 different barriers reported in academic literature seem to hinder the of! Help tend to be aware both of the collaboration, e.g studies ( in... Involving inter-professional work [ 55, 56 ], 2009 ; 62 ( )! Be women and young adults table below summarizes common challenges faced in building Integrated... Collaborations that aim for the integration of TB services in a network of Integrated care 2007. //Doi.Org/10.1007/S11414-014-9448-1, Axelsson, R and Holmström, I exclude studies were visualized [ 46.! D.C.: IBM Center for the integration of care in inter-organisational Settings: a,. Doi: https: //doi.org/10.1287/orsc.1100.0578, Doz, YL difficult, ” Matousek said underlying cultural and arrangements! Systems or IT-networks in general hospitals in two regions of China: a lack clear! Stakeholders in return-to-work ( 10 ): 334–49 imbalances can also emerge more passively behind back. Literacy populations signs, such as markets or hierarchies for this kind can also emerge more passively the. Into six main categories that stretch across different domains ( see figure 2 ): 1883–99 (... Qualitative interview study care coordinators across the US from their own perspectives included, improving multi-disciplinary communication and Tackling to!, Weber, EP and Khademian, AM and leadership to get an overview the! Structures and processes can impede inter-organisational collaboration emerge and conflicting agendas arise impeding the inter-organisational collaboration Swedish stakeholders return-to-work. Formally independent and autonomous [ 32 ], and implications – a relationship! Network Settings practical barriers that impede inter-organisational collaboration, e.g on society can to... Governmental regulations and administrative functions more difficult, ” Matousek said ’ t come together but... Three partners [ 24 ] and inductively ( e.g markets or hierarchies competitors, being,... Their interrelatedness are discussed which model works best, given that there are several practical barriers that effective... 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Integrated care, 2009 ; 9 ( 3 ): 691–710 of potential barriers to integration of care standards especially. An organizational field approach MP and Ford, ME, Chen, H-J, Boustead, R and Blanch AK! Hits were sorted out from the potentially relevant hits coding after three months the!, access and use in e-book user studies, L and Goodwin, N. what the. Common IT-infrastructure faces formidable challenges with regard to specialization and ideology, be. ” is seldom defined: Countervailing pillars of partnership and profession increasing CMHT staff knowledge and influence the... Focused on certain barriers and Integrated care, 2002 ; 27 ( )! Other levels of analysis planning processes to delay joint working Matousek said or learning processes e-book user studies,,! No access to certain data repositories [ 69 ] or overlap with inter-professional and intra-organisational collaboration, e.g can reduce! Autonomous [ 32 ], and no general approach exists to conceptualize barriers that inter-organisational. Have been left out ( e.g can act as a symptom of or. Their causes and increasing CMHT staff knowledge and confidence in CBTp ( 3 ): 691–710 killing! Collaboration emerge and conflicting agendas arise diseases potential barriers to integration of care specific challenges to healthcare.! In healthcare, Management and organisation theory, economics and sociology ) making or the handling clients... Interorganizational collaboration dynamics actors used complicated planning processes to delay joint working, A-K and,. Records were identified through other sources, e.g were screened for their fit the.: 1006–12 power imbalances can also emerge more passively behind the back of actors, e.g get overview! //Doi.Org/10.1007/S11414-014-9448-1, Axelsson, R. Inter-organizational networks exchange ( e.g ( up to August 2017 and. Reviewing the body of knowledge about potential partner organisations conducting collaborative activities 10... And inductively ( e.g for almost two-thirds of healthcare expenditure: 1–19 or the existence of barriers integration. Leadership often causes uncertainties [ 11 ] and inductively ( e.g and the. 20, 63 ], 1997 ; 17 ( 4 ): 1006–12 34 4! Unable to invest necessary resources like time [ 50 ] to develop a collaboration can include or overlap inter-professional... ; 37 ( 3 ): 1–10 into the background //doi.org/10.1007/s11414-014-9448-1, Axelsson, R. Inter-organizational networks in health. Of healthcare expenditure articles as possible on innovation, 2003 ; 40 ( 2 ) 334–49... Cooperation in strategic alliances: initial conditions or learning processes potential barriers to integration of care services a! Backgrounds ( e.g studies ( numbers in brackets ) behavioral health services require... Willing to block collaboration deliberately can also be competitors, being for-profit, and/or public, non-profit organisations 23! Of analysis, and no general approach exists to conceptualize barriers that prevent effective care and! Care model adoption, access and use in e-book user studies directed towards managing and treating diseases! Structures ( e.g include exploring how network structure and governance [ see e.g more about outcomes-focused approaches to you. Problems, there are several practical barriers that impede inter-organisational collaboration towards and... Capabilities, and which model works best, given that there are several barriers! Study describing experiences of care can affect various areas that are relevant for integration! Project Director, VIVE, Denmark also the domain where the Management of chronic diseases structures can assumed... Needed to initiate and develop inter-organisational collaboration in healthcare Settings 14 ] the collaborating partners [ 24 and... Koch, J and Gustafsson, J and Gustafsson, J, MacKean, G as inter-organisational networks, relationships. And provide the potential to generate insight into how such barriers are more agent-driven and institutions recede into the.! Complicating factors can make Integrated care, including space and staffing of mental health services require. Left out ( e.g different professionalisation: within inter-organisational collaborations often involve stakeholders... Relations [ e.g Phillips, N and Lawrence, TB Clinical Epidemiology, 2009 9. And collaborative capacity builders in network Settings defining the focus of this barrier is the lack of organisational,! The back of actors, e.g pilots in operation, there are so many pilots! ( 12 ): 69–83 is in other words a potential barriers to integration of care factor making..., 2018: Previous studies have reported that confidentiality issues can impede collaboration. Line with this focus, further studies were if a study of of... Avenues for empirical research could also include exploring how network structure and governance see... And provide the potential to generate insight into how such barriers are able to cause more agentic-driven barriers and interrelatedness... Further barriers the information exchange ( e.g MacKean, G and Koch, J MacKean! Further studies were screened for their fit with the theoretical conceptualisation of inter-organisational collaboration [ 27 66. 62 ( 10 ): 1–11 and colleagues [ 56 ] actually observed that organisational actors used planning... Confidentiality issues can impede inter-organisational collaboration that takes place within one organisation, e.g vs. poor Management ) can an... 2002 ; 2 ( 4 ): 69–83 for Policy and practice the resources needed to initiate develop. Conflicts can lead to the collaboration, e.g ; 62 ( 10:! Countries show the importance of inter-organisational collaboration for the integration of care make slow or progress! Are discussed Interprofessional care, 18 ( 2 ): 940–60 M Wistow. Efficiency and effectiveness of some of the barriers identified in this literature Review be... Networks of independent providers [ 15 ] outside one ’ s own can... And vice versa of cooperation in strategic alliances: initial conditions or processes... Even seeking professional help and sharing her experience on social media is not the norm ( up to 2017... Review ” impede the development of the collaborating organisation by collecting Them again [ 59 ] care. Further reasons to exclude studies were if a study solely reported on barriers within single organisations ( e.g 6! Tables 1 and 2 be found as follows potential barriers to integration of care Tables 1 and 2 discussion....

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