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FrancoAngeli Journals

Saggi

No. 126 (2023)

Collaborative governance: An opportunity to manage networked cancer care

DOI
https://doi.org/10.3280/mesa2023-126oa17288
Submitted
February 16, 2024
Published
2024-04-24

Abstract

In the current context of strong pressure towards the development of community assistance, as envisaged by the National Recovery and Resilience Plan, the article analyzes the territorial decentralization of oncological care at the Social and Health District of Aprilia (a city near Rome). The experience is interpreted in the light of the theory of Collaborative Governance as a virtuous example of inter-institutional collaborative network. Through a qualitative methodology that combines desk analysis, semi-structured interviews and site visits, it emerges that the success of this case is based on the presence of solid cross-functional relationships; on the clear identification of a common goal; on the motivation of professionals that triggers a process of humanization of care; on careful attention to logistical issues.
This case may serve as useful example for other contexts and for introducing similar innovations, even in other therapeutic areas.

References

  1. Abernethy A.P., Etheredge L.M., Ganz P.A., Wallace P., German R.R., Neti C. et al. (2010). Rapid-learning system for cancer care. J Clin Oncol., 28(27): 4268-74.
  2. Adams W. C. (2015). Conducting semi-structured interviews. Handbook of practical program evaluation, 4: 492-505.
  3. Agenas (2022). L’Oncologia di prossimità: esperienze a confronto. Quaderno di Monitor, novembre.
  4. AIOM (2022). I numeri del cancro in Italia. Report 2022. -- Accessibile a: https://www.aiom.it/i-numeri-del-cancro-in-italia/.
  5. Ambroggi M., Biasini C., Del Giovane C. et al. (2015). Distance as a barrier to cancer diagnosis and treatment: review of the literature. Oncologist, 20: 1378-85.
  6. American Society of Clinical Oncology (2017). The state of cancer care in America, 2017: a report by the American Society of Clinical Oncology. J Oncol Pract., 13(4): e353-e94.
  7. Bertolini M., Bevilacqua M., Ciarapica F.E. and Giacchetta G. (2011). Business process re‐engineering in healthcare management: a case study. Business Process Management Journal, 17(1): 42-66.
  8. Black L.J., Carlile P.R., Repenning N.P. (2004). A dynamic theory of expertise and occupational boundaries in new technology implementation: building on Barley’s study of CT scanning. Administrative Science Quarterly, 49(4): 572-607.
  9. Bobini M., Furnari A., Ricci A. (2020). Gli ospedali di piccole dimensioni del SSN: mappatura, profilo e prospettive nella rete ospedaliera nazionale. In: Cergas Bocconi (a cura di). Rapporto OASI 2020. Milano: Egea.
  10. Bobini M., Fattore G., Longo F., Meda F. (2022). La Casa della Comunità come piattaforma erogativa decentrata dell’ospedale Hub Il caso servizi oncologici della Casa della Salute di Bettola (AUSL PC). Mecosan – Open Access, (121). DOI: 10.3280/mesa2022-121oa14323.
  11. Boscolo P.R., Fenech L., Rappini V., Rotolo A. (2019). Tecnologia e innovazione nei modelli di servizio in sanità. In: Cergas Bocconi (a cura di). Rapporto OASI. Milano: Egea.
  12. Buchanan D., Addicott R., FitzGerald L., Ferlie E., Baeza J. (2007). Nobody in Charge: Distributed Change Leadership in Health Care. Human Relations, 60(7): 1065-1090.
  13. Camera dei Deputati, Servizio Studi Affari Sociali, 2021, Case della salute ed Ospedali di comunità: i presidi delle cure intermedie. Mappatura sul territorio e normativa nazionale e regionale, n. 144, 1.3.2021. -- http://documenti.camera.it/leg18/dossier/testi/AS0207.htm?_1619198796640.
  14. Cavanna L., Citterio C. et al. (2021). Le cure oncologiche ed ematologiche sul territorio secondo il modello dell’ASL di Piacenza. Rendiconto di 4 anni consecutivi. Recenti Prog Med, 112: 1-8.
  15. Delibera Giunta Regionale n. 643 del 26/07/2022. Regione Lazio. “Approvazione del documento “Linee Guida generali di programmazione degli interventi di riordino territoriale della Regione Lazio in applicazione delle attività previste dal Piano Nazionale di Ripresa e Resilienza e dal Decreto ministeriale 23 maggio 2022, n. 77”.
  16. Determinazione n. G01829 del 14/02/2023. Direzione Salute e Integrazione Sociosanitaria, Regione Lazio. “Approvazione del documento tecnico denominato “Linee di indirizzo organizzative per la Rete oncologica regionale ai sensi dell’Accordo Stato Regioni n. 59/CRS del 17 aprile 2019”.
  17. Edmondson A., Bohmer R., Pisano G. (2001). Disrupted routines: Team learning and new technology Implementation in Hospitals. Administrative Science Quarterly, 46(4): 685-716.
  18. Emerson K., Nabatchi T., Balogh S. (2011). An integrative framework for collaborative governance. J Public Adm Res Theory, 22(1): 1-29.
  19. Ferlie E., Fitzgerald L., McGivern G., Dopson S., Bennett C. (2013). Managed Cancer Networks: exemplars of evidence-based governementality. In: Making Wicked Problems Governable? The case of managed networks in health care. Oxford: Oxford University Press, pp. 73-96.
  20. Haines M., Brown B., Craig J., D’Este C., Elliott E., Klineberg E. et al. (2012). Determinants of successful clinical networks: the conceptual framework and study protocol. Implement Sci., 7: 16-25.
  21. Haward R. (2008). Organising a comprehensive framework for cancer control. In: Coleman M.P., Alexe D.-M., Albreht T. and McKee M. (eds.). Responding to the challenge of cancer care in Europe. Ljubljana (Slovenia): National Institute of Public Health of the Republic of Slovenia and European Observatory on Health Systems and Policies (EOHSP), pp. 113-134.
  22. Hebert R., Raiche M., Dubois M.F., Gueye N.R., Dubuc N., Tousignant M. (2010). Impact of PRISMA, a coordination-type integrated service delivery system for frail older people in Quebec (Canada): a quasi-experimental study. J Gerontol B Psychol Sci Soc Sci., 65b(1): 107-18.
  23. Lawrenz F., Keiser N., & Lavoie B. (2003). Evaluative site visits: A methodological review. American journal of evaluation, 24(3): 341-352.
  24. Leung A., Yau D., Liu C., Yeoh C., Chui T., Chi I. et al. (2004). Reducing utilisation of hospital services by case management: a randomised controlled trial. Aust Health Rev., 28(1): 79-86. Liberati E.G., Gorli M., Scaratti G. (2016). Invisible walls within multidisciplinary teams: disciplinary boundaries and their effects on integrated care. Soc Sci Med., 150: 31-9.
  25. Linnander E.L., Mantopoulos J.M., Allen N., Nembhard I.M., Bradley E.H. (2017). Professionalizing healthcare management: a descriptive case study. Int J Health Policy Manag., 6(10): 555-560.
  26. Ministero dell’Economia e delle Finanze (2021). Missione 6: Salute – Reti di prossimità, strutture e telemedicina per l’assistenza sanitaria territoriale. Piano Nazionale di Ripresa e Resilienza 2021: 224-227. -- www.governo.it/sites/governo.it/files/PNRR.pdf.
  27. Molin M.D., Masella C. (2016). From fragmentation to comprehensiveness in network governance. Public Organ Rev., 16(4): 493-508.
  28. Natow R. S. (2020). The use of triangulation in qualitative studies employing elite interviews. Qualitative research, 20(2), 160-173.
  29. Parry C., Kent E.E., Mariotto A.B., Alfano C.M., Rowland J.H. (2011). Cancer survivors: a booming population. Cancer epidemiology, biomarkers & prevention, 20(10): 1996-2005.
  30. Pessina E. A., Cicchetti A., Spandonaro F., Polistena B., D’Angela D., Masella C., ... & Sottoriva C. B. (2021). Proposte per l’attuazione del PNRR in sanità: governance, riparto, fattori abilitanti e linee realizzative delle missioni. Mecosan, 119: 89-117.
  31. Perrone F., Di Maio M., Efficace F. et al. (2019). Assessing financial toxicity in patients with cancer: moving away from a one-size-fits-all approach. J Oncol Pract., 15: 460-1.
  32. Pfannstiel M.A., Rasche C. (2019). Service Design and Service Thinking in Healthcare and Hospital Management. Cham, Switzerland: Springer International Publishing.
  33. Pitchforth E., Nolte E., Corbett J., Miani C., Winpenny E., van Teijlingen E., ... Ling T. (2017). Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies. Health services and delivery research, 5(19): 1-220.
  34. Provan K.G., Kenis P. (2008). Modes of network governance: structure, management, and effectiveness. J Public Adm Res Theory, 18(2): 229-52. 24.
  35. Provan K.G., Beagles J.E., Leischow S.J. (2011). Network formation, governance, and evolution in public health: the north American Quitline consortium case. Health Care Manag Rev., 36(4): 315-26.
  36. Smith J. (2001). Redesigning health care: radical redesign is a way to radically improve. BMJ, 322: 1257-8.
  37. Taplin S.H., Anhang Price R., Edwards H.M., Foster M.K., Breslau E.S., Chollette V. et al. (2012). Introduction: understanding and influencing multilevel factors across the cancer care continuum. J Natl Cancer Inst Monogr., (44): 2-10.
  38. Taplin S.H., Weaver S., Chollette V., Marks L.B., Jacobs A., Schiff G. et al. (2015). Teams and teamwork during a cancer diagnosis: interdependency within and between teams. J Oncol Pract., 11(3): 231-8.
  39. Tralongo P., Gebbia V., Mercadante S. et al. (2021). Cancer: new needs, new models. Is it time for a community oncologist? Another brick in the wall. Cancer, 13, 1919.
  40. Tremblay D., Latreille J., Bilodeau K., Samson A., Roy L. (2016). L’Italien M.-F. et al. Improving the transition from oncology to primary care teams: a case for shared leadership. J Oncol Pract., 12(11): 1012-9.
  41. Turrini A., Cristofoli D., Frosini F., Nasi G. (2010). Networking literature about determinants of network effectiveness. Public Adm., 88(2): 528-50.
  42. Valentine M.A., Edmondson A.C. (2015). Team Scaffolds: How Mesolevel Structures Enable Role-Based Coordination in Temporary Groups. Organization Science, 26(2): 405-422.
  43. Yin R.K. (2009). Case study research: Design and methods (Vol. 5). London: Sage.
  44. Yu E., Sangiorgi D. (2017). Service design as an approach to implement the value cocreation perspective in new service development. Journal of Service Research, 21(1): 40-58.
  45. Yu E., Sangiorgi D. (2018). Service design as an approach to implement the value cocreation perspective in new service development. Journal of Service Research, 21(1), 40-58.
  46. Whiting L.S. (2008). Semi-structured interviews: guidance for novice researchers. Nursing Standard, 22(23): 35-40.
  47. World Health Organization (WHO). National cancer control programmes: policies and managerial guidelines. Geneva: World Health Organization; 2002. -- https://apps.who.int/iris/bitstream/handle/10665/42494/9241545577.pdf ?sequence=1&isAllowed=y.
  48. Zahra A.S., George. G. (2002). Absorptive Capacity: A Review, Reconceptualization and Extension. Academy of Management Review, 27(2): 185-203.

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