More black box to explore: How collaborative partnerships shape integrated care

Abstract

Background: Forming collaborative partnerships is a prominent strategy that is used to promote integrated service delivery across health and social service systems. Evidence on the underlying collaboration process dynamics through which partnerships evolve in an integrated care setting lacks. This study explores the longitudinal relationship of collaboration process dynamics (shared ambition, insight in mutual gains, relationship dynamics, organisational dynamics, and process management) with the final success of an integrated care project (ICP). Methods: Fifty-nine ICP involved in a Dutch national program participated in a survey study. Four hundred-fifty responded at baseline and 426 questionnaires were returned at follow-up. Hierarchical multiple-regression-analyses were conducted to explore the relationship between baseline levels and the change of the collaboration dynamics and the final success of the ICP. Results: Mutual gains and process management at baseline were the most significant predictors for the final success. An increase in mutual gains, relationship dynamics and organisational dynamics during the collaboration process related positive to the final success of an ICP. Conclusions: Managing a successful ICP requires both hard and soft collaborative skills. As to hard skills, process control at the start and developing an effective governance mechanism throughout the collaboration process are needed. As regards to soft skills, being explicit about partners’ interests and building relational capital during the collaboration process are of interest.