Supporting integrated care on the organisational level: An exploration of the diversity in organisational practices in Belgian disability care

Background: Due to population ageing, the number of people with chronic health conditions and disabilities continues to rise, while the care workforce is not growing accordingly. As patients’ needs become more complex and diverse, disability care organisations are increasingly searching for alternative ways to organise the available workforce, with the aim of delivering more person-centred, continuous care. This research intends to explore the potential of interventions supporting care integration on the organisational level, by examining the diversity of organisational practices in the disability care sector.

 

Approach: A qualitative methodology is used. The study entails interviews with key informants, followed by a series of case studies. A number of Belgian disability care organisations are selected to study in depth based on the principle of maximum variation. Through semi-structured interviews with both the management of the organisations and care workers, data is gathered regarding the overall organisational structure as well as the daily operations and experiences of those who are closest to the patients. Cross-case analysis is used to identify similarities and differences between the organisations.

 

Results: First of all, preliminary findings show that disability care organisations differ according to some generic characteristics, such as client group, types of support offered, origin, size and source of financing. Second of all, differences between organisations also relate to how care work is organised.

 

Some relevant organisational characteristics identified in the first interviews can be grouped into a set of emerging overarching themes, including the distribution of tasks, the degree of deconcentration, the organisation of teams and the governance structure. Different combinations of these characteristics exist in practice.

 

Implications: This study describes relevant differences and similarities between organisations for persons with disabilities in Belgium with regard to how they organise their workforce. Besides advancing our understanding of the variation in organisational practices in the disability care sector, it also provides valuable insights for care practitioners and policymakers, as they can learn from the different approaches that are developed. More generally, our research highlights the role of organisational design choices in fostering the design and implementation of integrated care.