عوامل داخلی ساختاری و عملیاتی تأثیرگذار بر طراحی مدل حکمرانی شبکه در سیستم‌های مراقبت از سلامت: مرور نظام‌مند ادبیات
محورهای موضوعی : مدیریت دانشرضا عالیخانی 1 , علیرضا علی احمدی 2 , محمدرصا رسولي 3 *
1 - دانشگاه علم و صنعت
2 - دانشگاه علم و صنعت ایران
3 - دانشگاه علم و صنعت ایران
کلید واژه: سیستم‌های مراقبت سلامت عوامل تأثیرگذار ساختاری و عملیاتی طراحی مدل حکمرانی شبکه¬, ای مرور نظام¬, مند ادبیات,
چکیده مقاله :
با توجه بازار رقابتی امروزی در نظام سلامت، همکاری شبکه‌ای تبدیل به یک استراتژی اساسی جهت بقای سازمان‌ها شده است. توفیق راهبردی یک شبکه همکاری مستلزم بهره گیری از مدلی حکمرانی مناسب بین سازمان های ارائه دهنده خدمات در نظام سلامت است. عوامل گوناگونی بر طراحی موفق مدل حکمرانی شبکه ای در نظام سلامت تأثیرگذار هستند که توجه به این عوامل در طراحی موفق مدل حکمرانی شبکه‌ای حیاتی است. هدف از انجام این پژوهش شناسایی عوامل داخلی ساختاری و عملیاتی بوده که بر طراحی مناسب مدل حکمرانی شبکه‌ای در سیستم‌های ارائه خدمات سلامت اثر می‌گذارند. روش پژوهش: جهت شناسایی و استخراج فاکتورهای مورد نظر، از شواهد ذکر شده در ادبیات در استفاده می‌شود. بدین منظور نیازمند روشی هستیم که ادبیات موضوع را به‌طور جامع و سامانمند در نظر گیرد، برای رسیدن به این هدف مرور نظام‌مند ادبیات به منظور شناسایی شواهد معتبر و به‌عنوان روشی فراگیر و سامانمند در نظر گرفته شد. همچنین جهت ترکیب شواهد استخراج شده از روش گراندد تئوری بهره گرفته شد. یافته‌ها: با جستجوی در پایگاه داده‌ی WEB OF SCIENCE به‌عنوان یک پایگاه جامع و معتبر جهت کشف مطالعات مرتبط، 2350 مقاله حاصل گردید. غربالگری نتایج بر اساس متناسب بودن عناوین مقالات با معیارهای ورودی و خروجی مطالعات به 150 مقاله منجر گردید. نهایتاً با غربالگری 150 مقاله مذکور بر اساس تناسب چکیده و نتیجه‌گیری آن‌ها، به انتخاب 53 مقاله‌ی نهایی انجامید که طی مرور آن‌ها 87 قطعه شواهد از 37 انتشار علمی استخراج گردید و از مطالعات دیگر شواهدی کشف نشد. جهت ایجاد دیدگاه جامع و دسترسی آسان به شواهد استخراج شده در مرحله‌ی ترکیب شواهد با استفاده از متدولوژی گراندد تئوری، 2 گروه از شواهد مجموعا شامل 16 کلاس ایجاد شد. نتیجه‌گیری: طراحی مدل حکمرانی در شبکه در صورتی موفق آمیز بوده که عوامل داخلی ساختاری و عملیاتی در طراحی آن در نظر گرفته شود. در این پژوهش عوامل مرتبط در دو دسته اصلی شامل عوامل مرتبط با مشخصات شبکه نظیر سطح انعطاف پذیری، سطح بلوغ منابع، سطح تمرکز در شبکه و عوامل مرتبط با ویژگی های حکمرانی شبکه مانند ساختار تصمیم گیری، مکانیسم های ارزیابی و مشروعیت در شبکه شناسایی شدند.
Introduction: todays, with regard to competitive market in health system collaboration networked clllaboration has become an essensial strategy for the survival of organizations. Network governance that refers to coordination and collaboration in the network is a fundamental concept that affect collaboration network success. There are various factors that affect designing successful model of network governance that considering this factors is critical for designing successful model of network governance. The aim of doing this research is identifying internal structural and operational factors that affects designing proper model of network governance in health care delivery systems. Methodology: to identify and extract desired factors used of the mentioned evidence in the literature related to research question. For this porpous we need a research methodology that comprehensively and systematically consider the literature. For achieving this aim a systematic literature review will consider as a comprehensive and systematic method for identifying valid evidence and related to the research question. Also, Grounded Theory method was used to synthesis the extracted evidence. Results: by searching in the WEB OF SCIENCE as a comprehensive and credible database for identifying related studies, the 2350 scientific publication resulted. By screening these results basis of title fitness with studies inclusion and exclusion criteria lead to select 150 articles. Finally, through screening described the 150 articles basis of their abstract and conclusion fitness lead to the 53 final articles that during the reviewing them the 78 pieces of evidences extracted from the 37 sources and did not identify any evidence from other studies. For creating extensive view and easy access to extracted evidences in the synthesizing step using granded theory, 2 categories and 16 classes emerged. Conclusion: designing governance model in the network will be successful if only internal structural and operational factors influencing on designing it have been considered. Structural and operational factors in the network include network characteristics and network administration characteristics, are influencing factors that considering these factors on designing proper model of governance lead to fitness of the goernance model with network characteristics that finally lead to collaboration network success.
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