Should nurses be leaders of integrated health care?
OBJECTIVE
To examine the role of nurses within integrated health care.


BACKGROUND
Healthcare planners are overly concerned with the treatment of diseases and insufficiently focused on social cohesion vertical rather than horizontal integration of healthcare effort. These domains need to be better connected, to avoid medicalization of social problems and socialisation of medical problems.


RESULTS
Published literature, related to theories of whole system integration. *When conceptualizing whole system integration it helps to consider research insights to be snapshots of more complex stories-in-evolution, and change to be the result of ongoing community dance where multiple players adapt their steps to each other. *One image that helps to conceptualize integration is that of a railway network. Railway tracks and multiple journeys are equally needed; each requiring a different approach for success. *Traditional nursing values make nurses more attuned to the issues of combined vertical and horizontal integration than medical colleagues.


CONCLUSIONS
Nurses should lead integration at the interface between horizontal and vertical activities.


CONCLUSIONS
Nursing managers and universities should support the development of nurses as leaders of whole system integration, in partnership with local healthcare organizations.
Thomas
Paul
P
Centre for the Study of Policy and Practice, Thames Valley University, London, UK. paul.thomas@tvu.ac.uk
While
Alison
A
D003266:Continuity of Patient Care / Q000458:organization & administration*; D004509:Education, Nursing, Continuing; D018166:Health Care Reform / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D007373:Interinstitutional Relations; D007857:Leadership; D017146:Models, Organizational; D009718:Nurse Administrators / Q000193:education / Q000458:organization & administration*; D024802:Nurse's Role; D009936:Organizational Innovation; D010344:Patient Advocacy; D010686:Philosophy, Medical; D010687:Philosophy, Nursing; D011320:Primary Health Care / Q000458:organization & administration; D013192:Staff Development; D013222:State Medicine / Q000458:organization & administration*; D018511:Systems Integration; D013850:Thinking; D006113:United Kingdom