title: Barriers of inter-organisational integration in vocational rehabilitation.
abstract: BACKGROUND
  A project of vocational rehabilitation was studied in Sweden between 1999 and 2002. The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service. The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration.
  
  
  BACKGROUND
  Theories of inter-professional and inter-organisational integration, and theories on organisational change.
  
  
  METHODS
  In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002. A thematic approach was used for the analysis of the data.
  
  
  RESULTS
  THREE DIFFERENT MAIN THEMES OF BARRIERS EMERGED FROM THE DATA: A Uncertainty, B Prioritising own organisation and C Lack of communication. The themes are interconnected in an intricate web and hence not mutually exclusive.
  
  
  CONCLUSIONS
  The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration. Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project. This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication. A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration.
authors.affiliation: Nordic School of Public Health, P.O. Box 12133, SE-402 42 Göteborg, Sweden and Stockholm Centre for Public Health, P.O. Box 17533, SE-118 91 Stockholm, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Wihlman
authors.forename: Cecilia Stålsby
authors.initials: CS
authors.lastname: Lundborg
authors.forename: Runo
authors.initials: R
authors.lastname: Axelsson
authors.forename: Inger
authors.initials: I
authors.lastname: Holmström