Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration

Michaela Kerrissey; Maike Tietschert; Zhanna Novikov; Hassina Bahadurzada; Anna D. Sinaiko; Veronique Martin; Sara J. Singer

doi:10.1177/10775587211024796

Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration

Michaela Kerrissey^*
, Maike Tietschert
, Zhanna Novikov
, Hassina Bahadurzada
, Anna D. Sinaiko
, Veronique Martin
, Sara J. Singer

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

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Abstract

More is known about the structural features of health system integration than the social features—elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). We surveyed practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems (828 responses; 61%). Building on prior theory, we developed and established the psychometric properties of survey measures describing normative and interpersonal integration. Normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration (e.g., a 1-point increase in a practice’s normative integration was associated with 0.53-point higher job satisfaction and 0.77-point higher perceived care quality in the practice, measured on 1 to 5 scales, p <.01). Variation in social features of integration may help explain why some health systems better integrate care, pointing to normative and interpersonal integration as potential resources for improvement.

Original language	English
Pages (from-to)	359-370
Number of pages	12
Journal	Medical Care Research and Review
Volume	79
Issue number	3
Early online date	16 Jun 2021
DOIs	https://doi.org/10.1177/10775587211024796
Publication status	Published - Jun 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported through the RAND Center of Excellence on Health System Performance, which is funded through a cooperative agreement (1U19HS024067-01) between the RAND Corporation and the Agency for Healthcare Research and Quality.

Publisher Copyright:
© The Author(s) 2021.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported through the RAND Center of Excellence on Health System Performance, which is funded through a cooperative agreement (1U19HS024067-01) between the RAND Corporation and the Agency for Healthcare Research and Quality.

Funders	Funder number
National Institutes of Health	U19HS024067
Agency for Healthcare Research and Quality

Keywords

burnout
care quality
health systems
integration

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10.1177/10775587211024796

Social features of integration in health systems and their relationship to provider experience, care quality and clinical integrationFinal published version, 293 KBLicence: Article 25fa Dutch Copyright Act

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Cite this

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abstract = "More is known about the structural features of health system integration than the social features—elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). We surveyed practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems (828 responses; 61\%). Building on prior theory, we developed and established the psychometric properties of survey measures describing normative and interpersonal integration. Normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration (e.g., a 1-point increase in a practice{\textquoteright}s normative integration was associated with 0.53-point higher job satisfaction and 0.77-point higher perceived care quality in the practice, measured on 1 to 5 scales, p <.01). Variation in social features of integration may help explain why some health systems better integrate care, pointing to normative and interpersonal integration as potential resources for improvement.",

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AU - Sinaiko, Anna D.

AU - Martin, Veronique

AU - Singer, Sara J.

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Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration

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