Network, see atomized organisation
A network … emerges from the bottom up; individuals function as autonomous ndoes, negotiating their own relationships, forging ties, coalescing into clusters. There is no ‘top’ in a network; each node is equal and self-directed. Democracy is a kind of network; so is a flock of birds, or the World Wide Web.
Four types of health network have been recognised and placed in a hierarchy.
• Clinical Association. This is an informal group that corresponds or meets to consider clinical topics, best practice and other areas of interest.
• Clinical Forum. This is a more formal group that meets regularly and has an agenda that focuses on clinical topics. There is an agreement to share audit and formulate jointly agreed clinical protocols.
• Developmental Network. This group is a Clinical Forum that has started to develop a broader focus other than purely clinical topics, with an emphasis on service improvement.
• Managed Clinical Network. This network, which includes the function of a Clinical Forum, has a formal management structure with defined governance arrangements and specific objectives liked to a published strategy
The Scottish Office described their function as being:
..linked groups of health professionals and organisations from primary, secondary and tertiary care working in a coordinated manner, unconstrained by existing professional and existing [organisational] boundaries to ensure equitable provision of high quality clinically effective services.’
These are enterprises in which people exchange things with one another.
No single network theory exists and most key informants stated that no particular network model was used to guide the development of their networks. Although multiple frameworks have been identified (including network life-cycles, levels and characteristics; networks as complex adaptive systems; and communities of practice), the following factors are consistently recognized as critical to network success:
• Establish clear purpose and goals
• Address the “hierarchy of needs”
• Include a culture of trust in stated core values
• Fulfill specific role functions such as effective leadership, sponsorship, knowledge brokerage and community membership
• Maintain a flexible infrastructure
• Establish supportive processes
• Balance homogeneity and heterogeneity
• Secure adequate resources
• Demonstrate value
Networks are characterized by social interaction and knowledge-sharing related to a common goal within a specific domain of knowledge and practice.
Tightly coupled; Network a “disturbance” or change in any one of them would quickly have ramifications for all the others.