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Net benefits: Assessing the effectiveness of clinical networks in Australia through qualitative methods

Cunningham, Frances C., Ranmuthugala, Geetha, Westbrook, Johanna I. and Braithwaite, Jeffrey (2012). Net benefits: Assessing the effectiveness of clinical networks in Australia through qualitative methods. Implementation Science,7:1-13.

Document type: Journal Article
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ARC Grant No. DP0986493
IRMA ID 75039815xPUB501
Title Net benefits: Assessing the effectiveness of clinical networks in Australia through qualitative methods
Author Cunningham, Frances C.
Ranmuthugala, Geetha
Westbrook, Johanna I.
Braithwaite, Jeffrey
Journal Name Implementation Science
Publication Date 2012
Volume Number 7
eISSN 1748-5908
Scopus ID 2-s2.0-84868258285
Start Page 1
End Page 13
Total Pages 13
Place of Publication United Kingdom
Publisher BioMed Central
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improving patient care in Australia. With significant investment in such networks in Australia and internationally, it is important to assess their effectiveness and sustainability as implementation mechanisms.

Methods
In two purposively selected, musculoskeletal clinical networks, members and stakeholders were interviewed to ascertain their perceptions regarding key factors relating to network effectiveness and sustainability. We adopted a three-level approach to evaluating network effectiveness: at the community, network, and member levels, across the network lifecycle.

Results
Both networks studied are advisory networks displaying characteristics of the ‘enclave’ type of non-hierarchical network. They are hybrids of the mandated and natural network forms. In the short term, at member level, both networks were striving to create connectivity and collaboration of members. Over the short to medium term, at network level, both networks applied multi-disciplinary engagement in successfully developing models of care as key outputs, and disseminating information to stakeholders. In the long term, at both community and network levels, stakeholders would measure effectiveness by the broader statewide influence of the network in changing and improving practice. At community level, in the long term, stakeholders acknowledged both networks had raised the profile, and provided a ‘voice’ for musculoskeletal conditions, evidencing some progress with implementation of the network mission while pursuing additional implementation strategies.

Conclusions
This research sheds light on stakeholders’ perceptions of assessing clinical network effectiveness at community, network, and member levels during the network’s timeline, and on the role of networks and their contribution. Overall, stakeholders reported positive momentum and useful progress in network growth and development and saw their networks as providing valuable mechanisms for meeting instrumental goals and pursuing collaborative interests. Network forms can prove their utility in addressing ‘wicked problems,’ and these Australian clinical networks present a practical approach to the difficult issue of clinician engagement in state-level implementation of best practice for improving patient care and outcomes.
Keywords Clinical networks
Health care
Quality improvement
Health systems
Organization of care
DOI http://dx.doi.org/10.1186/1748-5908-7-108   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 2.0 License
URL https://creativecommons.org/licenses/by/2.0/


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