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Taking Policy-Practice Gaps Seriously: The Experience of Primary Health Care Networks in Western Canada

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The Reform of Health Care

Part of the book series: Organizational Behaviour in Health Care series ((OBHC))

Abstract

What happens between the development of a broadly espoused public policy and its effective implementation? How do health care organisations actually implement government policies when those policies are of an over-arching nature, providing direction but few specifics? These questions are not new, but we still struggle to find answers that benefit both policy-makers and service providers.

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References

  • Anderson, J.E. (1984) Public Policy Making: An Introduction, 3rd Ed. Boston: Houghton Mifflin Co., 3.

    Google Scholar 

  • Auffrey, L. (2004) ‘Primary health care: Saskatchewan nurses lead the way’, Canadian Nurse, 100(3): 28.

    Google Scholar 

  • Balogun, J. and Johnson, G. (2005) ‘From intended strategies to unintended outcomes: The impact of change recipient sensemaking’, Organization Studies, 26(11): 1573–1601.

    Article  Google Scholar 

  • Casebeer, A.L. and Hannah, K.J. (1998) ‘The process of change related to health policy shift: Reforming a health care system’, International Journal of Public Sector Management, 11(7): 566–582.

    Article  Google Scholar 

  • Casebeer, A.L., Scott, C.M. and Hannah, K.J. (2000), ‘Transforming a health care system: Managing change for health gain’, Canadian Journal for Public Health, 91(2): 89–93.

    Google Scholar 

  • Casebeer, A.L., Reay, T., Golden-Biddle, K., Hinings, B. and GermAnn, K. (2010) ‘Primary health care innovation sites: Learning to create new cultures of care’, in Braithwaite, J., Hyde, P. and Pope, C. (eds) Culture Climate and Terms in Health Care Organizations. Houndmills, Basingstoke: Palgrave Macmillan.

    Google Scholar 

  • Colebatch, H.K. (1998) Policy: Concepts in the Social Sciences. Buckingham, U.K.: Open University Press, p. 122.

    Google Scholar 

  • Delmestri, G. and Walgenbach, P. (2005) ‘Mastering techniques or brokering knowledge? Middle managers in Germany, Great Britain and Italy’, Organizing Studies, 20/2: 195–218.

    Google Scholar 

  • Dye, T.R. (1981) Understanding Public Policy, 4th Ed. Englewood Cliffs, NJ: Prentice-Hall, p. 1.

    Google Scholar 

  • Evans, T. (1986) ‘Managing the environment. Introduction’, Managers as Strategists. Ed. G. Parston. London: King’s Fund Publishing Office.

    Google Scholar 

  • Falkenberg, J. (2006) ‘Moving strategy through the organization: The co-evolution of strategy formulation and implementation’, in Lines, R., Stensaker, I.G. and Langley, A. (eds) New Perspectives on Organizational Change and Learning. Bergen, Norway: Fagbokforlaget, pp. 68–92.

    Google Scholar 

  • Glaser, B. and Strauss, A.L. (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine.

    Google Scholar 

  • Greenhalgh, T., Robert, G., Bate, P., Kyriakidou, O., Macfarlane, F. and Peacock, R. (2004) How to Spread Good Ideas: A Systematic Review of the Literature on Diffusion, Dissemination, and Sustainability of Innovations in Health Service Delivery and Organizations: 424. National Coordination Centre for NHS Service Delivery and Organisation R&D. Page 604.

    Google Scholar 

  • Hall, T.E. and O’Toole, L.J. (2000) ‘Structures for policy implementation: An analysis of national legislation’, 1965–1966 and 1993–1994. Administration & Society, 31(6): 667–686.

    Article  Google Scholar 

  • Hill, M. and Hupe, P. (2002) Implementing Public Policy. London: Sage.

    Google Scholar 

  • Hinings, C.R., Casebeer, A.C., Golden-Biddle, K., Greenwood, R., Reay, T. and Pablo, A. (2001) ‘The regionalization of healthcare in Alberta: Legislated change, loose coupling and uncertainty’, Presentation at Academy of Management conference, Washington DC.

    Google Scholar 

  • Hinings, C.R., Casebeer, A., Reay, T., Golden-Biddle, K., Pablo, A. and Greenwood, R. (2003) ‘Regionalizing healthcare in Alberta: Legislated change, uncertainty and loose coupling’, British Journal of Management; 4: S15–S30.

    Article  Google Scholar 

  • Howlett, M. (2000) ‘Managing the “hollow state”: Procedural policy instruments and modern governance’, Canadian Public Administration, 43(4): 412–431.

    Article  Google Scholar 

  • Howlett, M. and Ramesh, M. (1995) Studying Public Policy: Policy Cycles and Policy Subsystems. Toronto: Oxford University Press.

    Google Scholar 

  • Hutchinson, B., Abelson, J. and Lavis, J. (2001) ‘Primary care in Canada: So much innovation, so little change’, Health Affairs, 20(3).

    Google Scholar 

  • Jenkins, W. (1978) Policy Analysis. New York: St. Martin’s Press, p. 15

    Google Scholar 

  • Kuhl, S., Schnelle, T. and Tillmann, F-J. (2005) ‘Lateral leadership: An organizational approach to change’, Journal of Change Management, 5(2): 177–189.

    Article  Google Scholar 

  • Martin-Misener, R., McNab, J., Sketris, I.S. and Edwards, I. (2004) ‘Collaborative practice in health systems change: The Nova Scotia experience with the Strengthening Primary Health Care Initiative’, Canadian Journal of Nursing Leadership, 17(2): 33–45. Meier, K.J. and O’Toole, L.J. (2003) ‘Public management and educational performance: The impact of managerial networking’, Public Administration Review, 63(6): 689–699.

    Article  Google Scholar 

  • Mintzberg, H. (1987) ‘Crafting strategy’, Harvard Business Review, 66–75.

    Google Scholar 

  • Oandasan, I.F., Luong, L. and Wojtak, A. (2004) ‘Family physicians and home care agencies – valuing each other’s roles in primary care’, Healthcare Quarterly, 7(4): 49–52.

    Article  Google Scholar 

  • Pal, Leslie A. (1992) Public Policy Analysis. An Introduction. Scarborough, Ontario: Nelson Canada. A Division of Thomson Canada Limited, 303.

    Google Scholar 

  • Pal, Leslie A. (2006) Beyond Policy Analysis: Public Management in Turbulent Times. Scarborough, Ontario: Nelson Canada. A Division of Thomson Canada Limited.

    Google Scholar 

  • Pettigrew, A.M. (1990) ‘Longitudinal field research on change: Theory and practice’, Organization Science, 1(3): 267–292.

    Article  Google Scholar 

  • Reay, T., Casebeer, A., Golden-Biddle, K. and Hinings, C.R. (2009) ‘Learning in primary health care innovation’, CIHR: FRN#78710.

    Google Scholar 

  • Reay, T. and Hinings, C.R. (2009) ‘Managing the rivalry of competing logics’, Organization Studies, 30(6): 629–652.

    Article  Google Scholar 

  • Romanow, R. and Future of Health Care in Canada Commission (2002) Building on Values: The Future of Health Care in Canada – Final report [Romanow Report]. Commission on the Future of Health Care in Canada .

    Google Scholar 

  • Strauss, A. and Corbin, J. (1994) ‘Grounded theory methodology: An overview’, in Denzin, N.K. and Lincoln, Y.S. (eds) Handbook of Qualitative Research. Thousand Oaks: Sage, pp. 273–285.

    Google Scholar 

  • Stewart, J. (2000) Primary Care Reform in Canada: An Overview. Calgary, Alberta: Canada West Foundation.

    Google Scholar 

  • Thompson, J.R. and Fulla, S.L. (2001) ‘Effecting change in a reform context. The National Performance Review and the contingencies of “Microlevel” reform implementation’, Public Performance & Management Review, 25(2), 155–175.

    Article  Google Scholar 

  • Whittington, R. and Whitehall, M. (1996) ‘Strategy as practice’, Long Range Planning, 29(5): 731–736.

    Article  Google Scholar 

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© 2012 Ann Casebeer and Trish Reay

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Casebeer, A., Reay, T. (2012). Taking Policy-Practice Gaps Seriously: The Experience of Primary Health Care Networks in Western Canada. In: Dickinson, H., Mannion, R. (eds) The Reform of Health Care. Organizational Behaviour in Health Care series. Palgrave Macmillan, London. https://doi.org/10.1057/9780230355026_15

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