title: Regional planning implementation and its impact on integration of a mental health care network.
abstract: 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.
authors.affiliation: Psychiatric Department, McGill University, 1033 Avenue des Pins Ouert, Montréal, Québec, Canada. flemar@douglas.mcgill.ca
authors.forename: Marie Josée
authors.initials: MJ
authors.lastname: Fleury
authors.forename: Céline
authors.initials: C
authors.lastname: Mercier
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Denis
mesh_terms: 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*