A conceptual framework for understanding interorganizational relationships between nursing homes and emergency...

Nursing home residents who experience exacerbations of chronic health conditions or new illnesses must generally go to the emergency department for health care. This reliance on two distinct settings of care requires organizations to engage in an interorganizational relationship, which can be problematic, particularly when each organization has its own governing structures, policies, practices, and culture. Although it is widely acknowledged that interorganizational relationships can be the source of much frustration and conflict, little is known about their underpinnings. In this article, the authors draw on the literature to explore the interorganizational relationship that emerges each time a resident transfers between a nursing home and an emergency department in Canada. The authors apply this knowledge to develop a conceptual model that can be used to explore other interorganizational relationships that are formed when patients move between settings of care.