Abstract
Regional collaboration is needed to deal with current shortages and challenges in Dutch healthcare. But there are a lot of different levels and scales to organize healthcare in regions. For example by Public health service areas, hospital catchment areas, provinces and healthcare offices. This can lead to what we call 'network congestion' and raises questions like:
Would we structure healthcare the same way if we could start with a blank map?
At what level is each type of care organized?
What do we arrange at the neighborhood level, what at the regional level, and what at the national- or even international level?
At Vilans we support different regions in this search in the programs RegionStrenght and General Medical care in the region.
One of the methods to help understand how the joint projects on different scale levels contribute to the intended impact is the Theory of change. At Vilans, we work on devoloping Theories of change for for example regional initiatives and use data to learn from and improve our efforts.
Research has shown that scale is approached from different perspectives. We refer to these perspectives as “windows".
Utilizing multiple windows provides in addition to the theory of change method a more comprehensive understanding of scale-related issues. These windows help to identify, discuss, and analyse challenges more effectively within and between networks.