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首页> 外文期刊>Journal of Health Services Research_Policy >Partnership working in public health: the implications for governance of a systems approach
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Partnership working in public health: the implications for governance of a systems approach

机译：在公共卫生领域开展合作的伙伴关系：对系统方法治理的影响

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Objectives: Most of the research on partnerships has centred on health and social care, and while many of thenfindings remain relevant, public health partnerships concerned with ‘wicked issues’ give rise to a different andnmore complex set of issues which merit exploration. The study aimed to identify those factors promotingneffective partnership working for health improvement; to assess the extent to which partnership governancenand incentive arrangements were commensurate with the complexities of the problem; and to explore how farnlocal partnerships contributed to better outcomes for individuals and populations.nMethods: A three-year study of public health partnerships (2007–10) in nine localities across Englandninvolving semi-structured interviews at strategic and operational levels.nResults: Successful partnerships shared a number of characteristics: they were clear about goals and purpose;nthey were aware of partners’ roles and responsibilities; and they had a clear strategic overview of performancenthrough robust monitoring and evaluation. In many cases, partnerships were facades with a ‘silo mentality’nprevailing – there was an unwillingness to share information or resources, or to accord partnership workingnsufficient priority or support. Despite enthusiasm for partnerships and an insistence that they were essential,nit was impossible to establish evidence of their impact on health outcomes. While the focus on partnershipsntends to be on structures, relational factors, including high levels of trust and goodwill, were importantningredients of a well-functioning partnership. Less formal and more organic, operational partnerships werenmore effective than more formal, strategic level ones which were driven by targets. Finally, partnerships were,nin part, shaped by the national policy context, with constant policy and organizational churn making itndifficult to sustain long-term relationships.nConclusions: Future partnerships might be undertaken differently, adopting a complex adaptive systemsnperspective. This advocates an approach to partnership working that is less focused on rigid structures andnmuch more on relational factors like trust and goodwill
机译：目标：关于伙伴关系的大多数研究都集中在卫生和社会保健上，尽管当时的许多发现仍然有意义，但与“邪恶问题”有关的公共卫生伙伴关系却引发了一系列不同而又更为复杂的问题，值得探讨。该研究旨在确定促进有效伙伴关系促进健康的那些因素；评估伙伴关系治理和激励安排在多大程度上与问题的复杂性相称； n方法：对英格兰9个地区的公共卫生伙伴关系进行了为期三年的研究（2007-10），涉及战略和运营层面的半结构化访谈。n结果：成功的伙伴关系具有许多特征：明确目标和目的；意识到合作伙伴的角色和责任；通过强大的监控和评估，他们对性能有了清晰的战略概述。在许多情况下，合作伙伴关系是充满“孤岛心态”的门面–不愿意共享信息或资源，也不愿意给予合作伙伴关系以足够的优先权或支持。尽管人们对伙伴关系充满热情并坚持认为伙伴关系至关重要，但无法建立证据表明伙伴关系对健康成果的影响。伙伴关系的重点是结构，而关系因素，包括高度信任和商誉，是运作良好的伙伴关系的重要要素。非正式的，更加有机的，可操作的合作伙伴关系比目标驱动的更正式，更战略的伙伴关系更有效。最后，伙伴关系在一定程度上受国家政策环境的影响，政策和组织的不断变动使维持长期关系变得困难。n结论：未来的伙伴关系可能采取不同的方式，采用复杂的适应性制度。这提倡一种伙伴关系工作方法，该方法应较少关注刚性结构，而应更多地关注诸如信任和商誉之类的关系因素。

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