Network governance of Dutch intensive care units:state of affairs after implementation of the Quality Standard

Abstract

Objective: To study the current state of affairs concerning Dutch intensive care network governance in relation to known effective governance structures of network organisations. Methods: Six characteristics of intensive care networks were defined to determine the four contingency factors from the Provan & Kenis network governance models. The contingency factors were determined for all Dutch intensive care networks. An overview of the networks and characteristics was created by triangulation, using information from two national intensive care network meetings (November 2017 and June 2018) and semi-structured interviews by telephone with 10 network intensivists and / or network managers. Results: Based on the chosen characteristics, none of the Dutch intensive care networks has a governance structure according to one of the Provan & Kenis successful forms of governance. Each of the present networks has a governance structure with elements from two or three different types. Characteristics of the network administrative organisation and shared governance form overlap in 10 out of 15 networks. All networks have a form of governance in which at least one intensivist is represented. Conclusion: After implementation of the Quality Standard, the presence of networks of intensive care units covering the Netherlands is a fact. The network governance that has developed varies but none of the networks has a governance structure that matches with a proven effective governance structure. Based on theory, the network administrative organisation seems to be the most effective for larger networks, and shared governance for smaller networks