Strategic Intentions and Organisational Adaptations to a Non-mandated Professional Network Facilitating Knowledge-to-Practice in Healthcare Settings; A qualitative analysis

Abstract

The effective delivery of quality healthcare and related services is complex and fraught with problems often referred to as ‘wicked issues’. With obstacles such as reduced funding, staff shortages, an ageing population, the proliferation of long-term conditions, and other complex health issues, healthcare organisations have increasingly been under great strain, needing to deliver quality services alongside cost saving benefits. Networks emerged as a means through which healthcare organisations attempt to find solution to such problems. Inter-organisational networking is thought to provide opportunities for knowledge transfer and information sharing that lead to improvement in healthcare processes.
There has been a proliferation in the adoption of networks in Healthcare over the years, most of which have targeted aims; to improve co-ordination, delivery of care, and ultimately the quality of services. Socio-professional networks that are more focused on knowledge sharing and transfer, have received much less attention. There is a dearth of information about such non-mandated network development in context. Specifically lacking, is a detailed understanding of how such networks develop and operate in practice; including how organisations adapt to and use these networks in solving their internal problems. The process of adaptation by organisations to such networks, the benefits accrued as well as how such (intended) benefits can be optimized are less clear.
The UK Safer Patient Network is one such network, which was commissioned with the aim of fostering a culture of knowledge sharing in healthcare. There was a general expectation that network priorities which resonate with organizational or individual interests/focus will drive the growth of the network and its evolution into a thriving and vibrant member-led community.
This study explores the network dynamics by assessing its structure, membership, and perceived benefits. It is a longitudinal, comparative case-study, which employs mixed methods comprising semi-structured interviews, non-participant observation, and document reviews. At the broad network level, five network member organisations, (comprising a total of 74 interviews), were purposely chosen from across the four UK regions, (one from each, but two from the north and south of England). At the nested (network programme) level, a further four organisations, (13 interviews), were conducted to explore members’ experiences and perceptions of the network collaborative programmes.
This central argument of this thesis is that the network has developed in response to members’ perceptions about its potential to deliver solutions to their problems. Organisations are observed to exhibit strategic intentions in their level of engagement and participation in the network and its related programs. Structurally, the network has low density with members clustered around the key contacts who function as the conduit for network communication.
Various theoretical lenses have been used to provide an explanation of the observations. Organisational theory with emphasis on population ecology of organisations and complex adaptive systems theory provides the main lenses with which to explore the observed structure of the network development. Theories such as Wenger’s theory of engagement and resource dependency theories and social exchange theory provide further contextual understanding of the dynamics and social processes within the network. A conceptual (Organisational Ecology) model is developed to understand the organizations’ adaptation and dynamics within such networks. The network optimization for growth and development can be achieved through the key contacts functioning as effective connectors or boundary spanners, with cross-level coherence and good communication skills.
Given the incremental use of networks in healthcare, policy makers, funders and healthcare organisations will need to pay attention to such network development characteristics and contextual influences in order to optimise desirable benefits or outcomes.

Date of Award	16 Jun 2021
Original language	English
Awarding Institution	University of Bath
Supervisor	David Wainwright (Supervisor), Kenneth Judge (Supervisor) & Katherine Smith (Supervisor)