Integrated delivery of services and capacity for organisational change management in the Chilean public health network

Abstract

Introduction: Improving the delivery of health services remains a significant challenge in Latin Ame-rica. In Chile, there is an expectation that integrated service networks can be strengthened, allowing each Health District to develop improvement strategies tailored to the needs of the community and the coordination of the network. Considering the complexities involved in integrated work, this study examines the capacity for organizational change management within the Chilean public health network, focusing on the need to enhance service delivery.

Materials and Methods: A qualitative strategy was employed that involved semi-structured individual interviews. The sampling method was intentionally heterogeneous, incorporating 28 staff members from the public health network, covering various levels of care and specialties. Data analysis was conducted using thematic analysis, which facilitated the development of a framework consisting of three primary themes.

Results: Change management is both relevant and necessary. While it does pose challenges during implementation, there are components that can enhance its effectiveness. To foster the integration of services, it is crucial to ensure the continuity of initiatives and for specialized levels to communicate using a common language. Furthermore, it is necessary to develop and coordinate new strategies that encompass all three levels of care.

Discussion: In order to function cohesively, it is essential to establish a capacity for change manage-ment that strategically confronts existing obstacles. This involves fostering a culture of participation and collaboration, while ensuring that the methodologies and strategies employed are coherent, systematic, and sustainable over time.