The Organisational Infrastructure of a Canadian Rural Health Network: A Four-Year Longitudinal Survey Study

Area of Science:

• Health Systems Research
• Organizational Networks
• Rural Healthcare Delivery

Background:

• Formal networks are increasingly utilized to address complex health system challenges.
• The Rural Surgical and Obstetrical Networks (RSON) in British Columbia represents a novel network initiative.

Purpose of the Study:

• To evaluate the organizational performance of the RSON over a four-year developmental period.
• To identify key themes and tensions within the RSON's operational growth.

Main Methods:

• An annual 37-item survey was administered to RSON leaders from 2019 to 2022.
• Statistical analysis (Wilcoxon Mann-Whitney test) compared favorable ratings over time.
• Qualitative analysis of respondent comments identified key themes.

Main Results:

• A statistically significant increase in favorable ratings was observed for 65% of survey items over four years.
• RSON could improve by including more peripheral members in decision-making and formalizing structures.
• Three network tensions were identified: inclusiveness vs. efficiency, stability vs. flexibility, and network vs. health system operations.

Conclusions:

• Findings validate network theories and offer practical insights for implementing similar networks.
• The tension between network operations and health system operations is a significant factor in healthcare delivery settings.