How is interorganisational integration developed?

The aim was to describe and analyse the development of interorganisational integration using a Swedish vocational rehabilitation project as an example.

A project involving four different organisations was studied: social services, social insurance, employment office and health care. A qualitative approach was used for data collection such as semi-structured interviews, focus groups discussions and documents. In total, 51 interviews and 14 focus group discussions were performed with actors at different levels in the different organisations. The first two studies were interview studies with a phenomenographic approach. The third study was based on interviews and focus group discussions with a thematic analysis. For the fourth study a chronological case study of the process of organising was used to get a more holistic picture of the project. The results of the case study description were analyzed in order to find patterns in answer to the questions how and why the organising was done in the way it was.
The four studies combined reveal a project where the once desirable focus on clients had changed to focus on rules and structures in a bureaucratic way. The development of interorganisational integration resulted in scattered islands of interprofessional work in teams with no connection to one another. Thus, the vertical integration was higher than the horizontal.
The results indicate that in developing interorganisational integration, it is important to have a holistic and comprehensive picture of the entire project in its context and to understand the added value of working in a seamless way instead of working for short term gain in each department or organisation. In the process of changing ways of working there is also a need for change management that promotes client focus, interaction and communication as well as transparency of decisions and actions.