Abstract
Based on the broad research tradition in the field of organizational identity, insights on network identity building in the field of integrated care has started to gained attention in previous years. Like any network, integrated care networks are continuously challenged by the question of who they are as social systems. This study examines how the identity of a heterogeneous integrated care network evolves and shapes the development of integrated care collaboration over time. Prior research on integrated care networks, as social systems beyond the common dichotomous organizational forms of hierarchy and market, highlights the vital role of identity for the development of purpose-oriented and long-lasting interaction among healthcare organizations. However, conceptualizations of identity have frequently appeared on an individual and organizational level, rather than on a network level of analysis.
To better understand the social phenomenon of dynamic network identity building in the field of integrated care, this study explores how the identity of an integrated care network develops over a time period of 12 years. Thereby, the study elaborates on the role of reflexive practices in building and dynamically stabilizing both the network identity and the network development over time. The study investigates the development of network identity by applying a structuration-oriented practice perspective, reconstructing identity building as a bundle of reflexive practices.
The study employs a longitudinal and qualitative single case study of a Swiss integrated care network (InCareNet) to capture the dynamic development of integrated care. Data collection includes 33 semi-structured interviews, 37 non-participant observations, 153 archival records, and six reflection workshops. The data analysis is conducted based on an abductive research approach, which iterates between empirical data close to the field and theoretical insights.
The key contribution of the study lies in the development of a process model. This practice-oriented process model illustrates how network identity building dynamically stabilizes over time (focusing on the network identity building practices of narrating identity, establishing social locales, involving members, and creating commitment). The findings show how change can present an essential prerequisite of dynamically stabilizing network identity building over time. In addition, the study proposes that network identity building forms both a medium and an outcome of reflexive network development. Finally, the study reveals how identity building in an integrated care network can constitute a network community via continuity.
This research makes a theoretical contribution to the literature on integrated care networks by recognizing and analyzing the continuous reconstruction of network identity building over time. Furthermore, it enhances our understanding of collaboration work in the field of integrated care and sheds light on the dynamic process of social systems when answering the question: Who are we?