title: Working towards integrated community care for older people: empowering organisational features from a professional perspective.
abstract: Although multi-disciplinary cooperation between professionals is a prerequisite to provide integrated care in the community, this seems hard to realise in practice. Yet, little is known about the experiences of professionals who implement it nor about the organisational features professionals identify as empowering during this cooperation process. Therefore, a case study of a multi-disciplinary geriatric team was performed. The data-collection included observations of meetings, in-depth interviews and focus groups with professionals (N = 12). Data were analysed inductively and related to the three organisational levels within the model of organisational empowerment of Peterson and Zimmerman. Signs of empowering organisational features on the intraorganisational level were mutual trust and clear working routines. On the interorganisational level important features included improved linkages between participating organisations and increased insight into each other's tasks. Tensions occurred relating to the inter- and the extraorganisational level. Professionals felt that the commitment of the management of involved organisations should be improved just as the capacity of the team to influence (local) policy. It is recommended that policymakers should not determine the nature of professional cooperation in advance, but to leave that to the local context as well as to the judgement of involved professionals.
authors.affiliation: Fontys University of Applied Sciences, Department of Social Studies, Eindhoven, The Netherlands; Fontys University of Applied Sciences, Department of Nursing/Bachelor of Applied Gerontology, Eindhoven, The Netherlands. Electronic address: bienke.janssen@fontys.nl.
authors.forename: Bienke M
authors.initials: BM
authors.lastname: Janssen
authors.affiliation: Fontys University of Applied Sciences, Department of Nursing/Bachelor of Applied Gerontology, Eindhoven, The Netherlands.
authors.forename: Miranda W C
authors.initials: MW
authors.lastname: Snoeren
authors.affiliation: Catholic University Leuven, Faculty of Social Sciences and Research Institute for Labour and Society (HIVA), Leuven, Belgium.
authors.forename: Tine
authors.initials: T
authors.lastname: Van Regenmortel
authors.affiliation: VU University Medical Center, Department of Medical Humanities, EMGO Institute, Amsterdam, The Netherlands.
authors.forename: Tineke A
authors.initials: TA
authors.lastname: Abma
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000458:organization & administration*; D017144:Focus Groups; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D007407:Interviews as Topic; D017146:Models, Organizational; D009426:Netherlands; D016134:Organizational Policy; D010348:Patient Care Team / Q000458:organization & administration; D011209:Power, Psychological; D011787:Quality of Health Care / Q000458:organization & administration; D035502:Trust
keywords: Integrated care; Long-term community care; Multidisciplinary cooperation; Multidisciplinary teams; Older people; Organisational empowerment; Organisational reform