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Achieving provider engagement: providers' perceptions of implementing and delivering integrated care.

Ignatowicz A, Greenfield G, Pappas Y, Car J, Majeed A, Harris M - Qual Health Res (2014)

Bottom Line: Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care.Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services.Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, Birmingham, United Kingdom a.m.ignatowicz@bham.ac.uk.

No MeSH data available.


Evolving engagement experience.
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fig1-1049732314549024: Evolving engagement experience.

Mentions: We noted a distinct evolving engagement experience. In the early stages, the pilot’s managers successfully harnessed health care providers’ enthusiasm for the pilot by drawing on common shared values of improving quality of patient care through improved coordination. During the following months, the predominant narrative shifted to that of service reorganization and efficiency savings, and a top–down management style that led to tension and antipathy among the health care providers. Many withdrew from the pilot, dissatisfied with both the reduced autonomy and emphasis on organizational change. In the third stage, the remaining health care providers themselves began to view the pilot more in terms of service reorganization, rather than the loftier, emotive values of patient quality of care. This manifested itself in a somewhat ambivalent preoccupation only for the financial gains and savings that the pilot could bring to their own organizations. These findings are represented schematically in Figure 1.


Achieving provider engagement: providers' perceptions of implementing and delivering integrated care.

Ignatowicz A, Greenfield G, Pappas Y, Car J, Majeed A, Harris M - Qual Health Res (2014)

Evolving engagement experience.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4232313&req=5

fig1-1049732314549024: Evolving engagement experience.
Mentions: We noted a distinct evolving engagement experience. In the early stages, the pilot’s managers successfully harnessed health care providers’ enthusiasm for the pilot by drawing on common shared values of improving quality of patient care through improved coordination. During the following months, the predominant narrative shifted to that of service reorganization and efficiency savings, and a top–down management style that led to tension and antipathy among the health care providers. Many withdrew from the pilot, dissatisfied with both the reduced autonomy and emphasis on organizational change. In the third stage, the remaining health care providers themselves began to view the pilot more in terms of service reorganization, rather than the loftier, emotive values of patient quality of care. This manifested itself in a somewhat ambivalent preoccupation only for the financial gains and savings that the pilot could bring to their own organizations. These findings are represented schematically in Figure 1.

Bottom Line: Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care.Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services.Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, Birmingham, United Kingdom a.m.ignatowicz@bham.ac.uk.

No MeSH data available.