Regional planning implementation and its impact on integration of a mental health care network.
This article questions the effectiveness of a managerial tool in changing a health-care system. The process of implementing regional planning and its impact on creating integrated service networks is examined, using a case study and a multi-dimensional analytic model. This model highlights the influence of contextual, structural, cultural and dynamic factors on forming networks. The regional planning developed in the province of Québec (Canada), aimed at a major transformation of the mental health-care system. In each district, organizations working with people who have serious mental disorders were mobilized to plan and implement a more coordinated, continuous and diversified supply of services, under the direction of a regional health body. This study outlines the limitations of regional planning as a tactic for transforming the system. It recommends instead developing more diversified integration strategies to further the process of forming integrated service networks within a complex system. In conclusion, a brief discussion deals with the difficulties related to the study of systemic change implementation.
Fleury
Marie Josée
MJ
Psychiatric Department, McGill University, 1033 Avenue des Pins Ouert, Montréal, Québec, Canada. flemar@douglas.mcgill.ca
Mercier
Céline
C
Denis
Jean-Louis
JL
D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D018166:Health Care Reform; D006284:Health Plan Implementation; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D019982:Organizational Case Studies; D011792:Quebec; D012040:Regional Health Planning / Q000458:organization & administration*