Why networks are important to improvement in healthcare

Over the past few decades the concept of networks has received significant attention.  In a context where the organisation of health service delivery is becoming ever more complex and disaggregated with multiple agencies playing some role in these processes, shifting demographics and changing disease profiles, the increased prevalence of ‘wicked issues’ and rising consumer expectations, it is more important than ever that the broad ‘health network’ is able to communicate and to collaborate to ensure that resources are used efficiently and that services are effective and able to share best practice.

Organisations and actors within the broad health network interact in many ways on a day-to-day basis.  However, this is often in relational to the transactional business of service-delivery, rather than with the ongoing improvement of the broader system.  The latter is a significant challenge given that it does not always fit squarely as the responsibility of any one organisation or agency.  Conceiving of the Victorian health system as a network and inviting partners to think about possible modes of improvement across the system can be a helpful way to drive performance in a broad sense.

While networks are often spoken about as though they are all similar, there are multiple different forms of networks and each has implications in terms of what links these, the kind of contribution they can make and their potential weaknesses.  When considering developing a network it is important to understand the motivations for this – although in practice it is likely that not all partners will share precisely the same goals and aspirations.  From the literature there two particular characteristics of a successful network:

Allows for formal and informal links

Whilst formal links across this network will be helpful in underpinning activities and learning across this, the evidence suggests that formal processes can only take systems so far.  What high performing systems typically demonstrate is a high degree of relational capital across the system, where different individuals and agencies understand each other and can predict with a degree of certainty how these partner will behave in response to changes in the broader context.

Individual and organisational networks are equally important and both are essential

Bass (1974) identified that in order for leaders to be effective they need to achieve network centrality, establish areas of influence and span structural ‘holes’ regardless of the particular form of the network.  There is no doubt that individual relationships are crucial to the effective operation of networks, but any network purely rooted in individual contacts that did not connect with the broader aspirations of the organisations concerned – such as the need to pursue problem sharing and problem solving – would only either serve the interests of the individuals concerned and/or be short-lived.

Networks that are able to structure the interaction of individuals and organisations are typically viewed as being more effective in meeting their goals.  In these networks individuals are able to develop relational capital across organisational and sectoral boundaries, which they may leverage at a later date.