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Reading: Governance evolution in new integrated care models: Ontario Health Teams

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Governance evolution in new integrated care models: Ontario Health Teams

Authors:

Ross Baker ,

Institute of Health Policy. Management and Evaluation, University of Toronto, CA
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Michelle Nelson,

Institute of Health Policy. Management and Evaluation, University of Toronto Bridgepoint Collaboratory in Research and Innovation Lunenfeld-Tanenbaum Research Institute, CA
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Paula Blackstien-Hirsch

Institute of Health Policy. Management and Evaluation, University of Toronto Quality Thru Improvement, CA
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Abstract

Introduction: Creating effective governance of integrated care has been a challenge in many jurisdictions (Gauld, 2014; Minkman et al., 2021). Fifty Ontario Health Teams (OHTs) have been approved to design and deliver integrated care in regions across Ontario (population 14.5 million), with additional teams still in development.  Ontario Health Teams are voluntary partnerships of existing health, social and third sector service providers, and the provincial government has provided only minimal specifications for their leadership and governance. OHTs have developed Leadership Councils to guide initial planning. But governance of these efforts is still evolving and, currently, most OHTs have limited governance structures.

Aims, Objectives and Methods: Many OHTs are considering new structures to strengthen governance to support the development and implementation of new care models. This presentation identifies the challenges experienced in the design of new governance arrangements by Ontario Health Teams, describes the varying governance structures and processes under development, and identifies the views of leaders on how these new emerging entities and networks are likely to progress. Data for this presentation comes from in depth interviews with leadership council members and leadership coaches in 10 OHTs and survey responses from a larger sample of OHT leaders. 

Results: Ansell and Gash (2008) suggest several factors that underlie effective collaborative governance. These factors include the extent to which prior organizational relationships have been antagonistic or cooperative, the strength of leadership, the incentives for stakeholders to engage, and whether governance structures and processes support trust building and commitment. More broadly, these authors suggest that collaborative governance is a time-consuming process that needs to focus on building trust and interdependence. Our research will explore the extent to which these factors are present in the design and early experiences of emerging models for integrated care governance in Ontario Health Teams.

Conclusions: Resources, external incentives and pressures derived from prior relationships as well as expectations of funders and clients shape the design and evolution of governance in integrated care. This study employs an evidence-based framework to explore experiences across OHTs located in different geographies and serving different target populations.

Implications: Collaborative governance enables providers to link health and social care programs in developing a common agenda and mutually reinforcing activities. Previous research has identified key factors contributing to effective collaborative governance; findings from this research may contribute to the design and processes creating effective governance for Ontario Health Teams.
How to Cite: Baker R, Nelson M, Blackstien-Hirsch P. Governance evolution in new integrated care models: Ontario Health Teams. International Journal of Integrated Care. 2022;22(S3):290. DOI: http://doi.org/10.5334/ijic.ICIC22147
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Published on 04 Nov 2022.

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