Background
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1. To describe each OnkoAktiv network in regard to their major network characteristics and classify each network into their developmental stage of organizational forms.
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2. To define implications and tasks for demand-oriented network implementation and further development in exercise oncology.
Theoretical framework for the analysis of the OnkoAktiv networks
Methods
Sampling, data collection and study instruments
Network measurements
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• Node and tie attributes: task and profession of actors, tie distribution
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• Cohesion: number of nodes and ties, average degree
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• Centrality: degree and betweenness centrality
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• Macrostructure: core-periphery-structures
Data analysis
Linkage | Co-ordinated | Full integration | |
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Structural typology | Single actors within existing services are linked “service to service” | Single actors are coordinated by network managers (from within or outside the network) | A new program/service has been created with pooled benefits and recourse, sharing costs and defined tasks. Multidisciplinary teams control jointly all perspectives of the new service |
Actor responsibilities | Screen, inform and refer patients to “other services” within the care system, responsibilities are separate | Managers share clinical information, manage transitions, coordinate benefits and the sequence of services (“care management”) Network actors/groups not bounded by any binding contract, responsibilities remain separate | Multi-disciplinary professional teams with joint clinical and contractual responsibilities Apply case management |
Administrational body | None | Administration through elected network members | Managed through an individual, neutral administrative body |
Patients’ needs | Universal | Targeted | Specialist |
Data visualisation
Results
Descriptive statistics
Networks | G | I | L | M | D | H | J | E | B | C | A |
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# of nodes | 12 | 16 | 17 | 19 | 19 | 23 | 26 | 32 | 33 | 39 | 52 |
# of ties | 56 | 92 | 68 | 148 | 166 | 216 | 190 | 224 | 202 | 478 | 530 |
Average Degree | 4.7 | 5.75 | 4.0 | 7.8 | 8.7 | 9.4 | 7.3 | 7.0 | 6.1 | 12.3 | 10.2 |
Tie attributes | |||||||||||
Patient-related [%] | 50.0 | 56.3 | 64.7 | 84.2 | 63.1 | 69.6 | 65.4 | 65.6 | 72.7 | 38.5 | 52.9 |
Influence [%] | 58.3 | 68.8 | 58.8 | 36.8 | 52.6 | 47.8 | 69.2 | 75.0 | 45.5 | 82.1 | 82.4 |
Finances [%] | 16.7 | 25.0 | 35.3 | 21.1 | 26.3 | 39.1 | 34.6 | 25.0 | 9.1 | 20.5 | 33.3 |
Public communication [%] | 50.0 | 81.3 | 70.6 | 57.9 | 36.8 | 69.6 | 23.9 | 56.3 | 75.8 | 25.6 | 35.3 |
Years of collaboration [Avg] | 6.8 | 4.0 | 4.9 | 3.9 | 1.0 | 6.3 | 4.8 | 1.8 | 2.1 | 5.1 | 7.0 |
Importance; 1–10 [Avg] | 7.0 | 5.9 | 7.2 | 6.3 | 7.3 | 7.0 | 4.8 | 8.4 | 6.7 | 6.5 | 5.7 |
Core nodes | |||||||||||
# of core nodes [n] | 7 | 2 | 3 | 11 | 13 | 8 | 7 | 5 | 3 | 15 | 6 |
[%] of total nodes | 58 | 13 | 18 | 58 | 68 | 35 | 27 | 16 | 9 | 39 | 12 |
Node and tie attributes: what are the tasks and professions of the network actors?
Cohesion: number of nodes and ties, average degree
Centrality: who are actors in the center of the network?
Macrostructure of OnkoAktiv networks
Network classification: continuum of organizational forms
Linkage
Co-ordinated networks
Full integration
Discussion
Node and tie attributes: what are the tasks and professions of the network actors?
Cohesion: number of nodes and ties, average degree
Centrality: who are actors in the center of the network?
Organisational forms in exercise oncology: implications for the network OnkoAktiv
Operation | Linkage | Co-ordination | Full Integration |
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Function of coordinators | Initiation of collaboration between stakeholder and professional leader, support of communication and share of knowledge. Definition of network vision and mission statement Clarify and define jointly individual tasks, responsibilities and proposals of each network member | Administration of network members, align network goals to “core business” of network members Support shared vision, keep individual responsibilities in subgroups, create joints for collaboration and a “platform” for communication (e.g. regular meetings) | Provision of all care services as integrated care model. Develop a new administrative system and a shared vision and mission statement. Implement pooled funding options |
Key player involvement | Analysis of “core”-actors and important key player inside the organisation: Involvement of clinical managers, heads of exercise or oncology department, leading clinical nurses and oncologists | Analysis of important and influential “peripheral”-actors inside and outside the organisation Inside: e.g. physio- and exercise therapy, urology, haemato-oncology, gastroenterology or breast care centers Outside: Involvement of health and annuity insurance, self-help groups or cancer care society | Fully integrate key player into a “new organisation” with multidisciplinary teams |
Funding | Individual/separate | Individual/separate | Individual/separate or pooled |
Patients need | Universal | Targeted | Specialist |