1. Networks in management: theory and practice Gray Southon School of Population Health University of Auckland Address: Gray@southon.net site: gray.southon.net

2. Networks in Management Prevalence and diversity –networks and networking. The underlying principles –related to hierarchies The challenges and opportunities –managers and educators

3. Networks & Networking Influence Advice Professional Medical Colleges Nurses Organisations Referral Services Mental Health Cancer Clinical Training Primary Care Policy Consultation Workforce Patient Support Alzheimers Cancer Disabled Stroke Old Boys’ NGOs

4. Communities of Practice “Communities of Practice” provide government leaders with a new tool for managing in a fast- paced, fluid environment where they need to reach beyond traditional organisational boundaries to solve problems, share ideas, and develop peer and stakeholder relationships. This approach has been successfully used in the private sector over the past decade, and is now being applied in the public sector. Snyder and Briggs 2003, Communities of practice: A new tool for government managers. (IBM & Harvard University) Available at http://www.businessofgovernment.org/pdfs/Snyder_report.pdf

5. GMCT Greater Metropolitan Clinical Taskforce - NSW http//www.health.nsw.gov.au/gmct/ Focused on single specialty service Take broad geographic view Involve representative clinicians –Allied Health, Nurses, Lab, physicians, surgeons. Include patient/community reps Provided substantial resources

6. GMCT Initiatives Equity of access Coordination of care Rationalising services Standards of care - protocols Patient information Data definition and collection Research programs

7. GMCT Programs Bone Marrow Transplant Severe Burns Spinal Cord injury Ophthalmology Cardiac Services Brain Injury Rehabilitation Neurosurgery Stroke Renal Services Radiology/Interventional Neuro-radiology Nuclear Medicine Gynaecological Oncology Metropolitan Hospitals Information Management & Technology Transition care chronic paed. Severe Trauma

8. !! BUT !! GMCT Networks Department/Area Hierarchy Conflict

9. Principles NetworksHierarchies

10. Principles

11. GMCT Issues

12. ??Networks or Hierarchies?? NetworksHierarchies !! Both !! ? Initiative Knowledge Innovation Structure Control Accountability

13. Challenges for Managers StyleSupportiveDirective CultureTrustAuthority CoordinationInter-network Services ActivityPromote NetworksIndividual/ Team management Responsive toMultiple Single authority influences AccountabilityEngagement.Performance measures NetworkHierarchy

14. Above All Reconciling Networks & Hierarchies

15. Opportunities for educators. Engage in networking –Enhance standards –Mutual support –Political interests Engage with networks –Education –Research

16. Conclusion Networks –Have always been around, but are becoming more prominent. –Bring many different principles. –Bring challenges and opportunities

17. Resources Southon G. Advancing Knowledge in Health: A knowledge-based health system. Presented at: NZIHM Conference: Advancing Knowledge for Quality Healthcare, Auckland 6-8 August 2003. Southon G, Perkins R and Galler D, Networks: a key to the future of health services, scheduled for publication Australian Health Review 29 (3) 2005. Southon G. Clinical Networking in NSW Health Services. Report April 2005. Available at: gray.southon.net