Reshaping health care governance using pilot projects as public policy implementation instruments

Pilot projects are often used to test innovations; however, pilot projects, viewed as tools, are rarely addressed as an object for research. This paper, in which pilot projects are viewed as public policy instruments producing specific effects, addresses the research question: how does the use of mu...

Full description

Bibliographic Details
Main Author: Mélanie De Winter
Format: Article
Language:English
Published: OpenEdition 2020-12-01
Series:International Review of Public Policy
Subjects:
Online Access:http://journals.openedition.org/irpp/1422
_version_ 1818666379391270912
author Mélanie De Winter
author_facet Mélanie De Winter
author_sort Mélanie De Winter
collection DOAJ
description Pilot projects are often used to test innovations; however, pilot projects, viewed as tools, are rarely addressed as an object for research. This paper, in which pilot projects are viewed as public policy instruments producing specific effects, addresses the research question: how does the use of multidisciplinary pilot projects as experimentation and implementation instruments reshape modes of public governance in the Belgian health sector in a context of transition and ongoing devolution? An ethnographic study was conducted, focusing on the specific case of the Belgian joint plan, “Integrated Care for Better Health”, which targets chronic patients and was intended to initiate a major transition from a fragmented to an integrated care system for chronic patients. The analysis concerns the specific implementation modalities designed by the authorities, which consisted of the launch of pilot projects involving professionals in the field coming from different sectors in an iterative and incremental co-creation process. This choice caused new vertical interdependences to emerge between the levels of the health care system, transforming the roles of both the authorities and hands-on professionals involved; it also denoted a transition towards a more negotiated governance, in the course of which several types of knowledge and evidence have been mobilised.
first_indexed 2024-12-17T06:03:36Z
format Article
id doaj.art-79c3705ab8fa4348a5b011ea42a1f32a
institution Directory Open Access Journal
issn 2679-3873
2706-6274
language English
last_indexed 2024-12-17T06:03:36Z
publishDate 2020-12-01
publisher OpenEdition
record_format Article
series International Review of Public Policy
spelling doaj.art-79c3705ab8fa4348a5b011ea42a1f32a2022-12-21T22:00:48ZengOpenEditionInternational Review of Public Policy2679-38732706-62742020-12-01210.4000/irpp.1422Reshaping health care governance using pilot projects as public policy implementation instrumentsMélanie De WinterPilot projects are often used to test innovations; however, pilot projects, viewed as tools, are rarely addressed as an object for research. This paper, in which pilot projects are viewed as public policy instruments producing specific effects, addresses the research question: how does the use of multidisciplinary pilot projects as experimentation and implementation instruments reshape modes of public governance in the Belgian health sector in a context of transition and ongoing devolution? An ethnographic study was conducted, focusing on the specific case of the Belgian joint plan, “Integrated Care for Better Health”, which targets chronic patients and was intended to initiate a major transition from a fragmented to an integrated care system for chronic patients. The analysis concerns the specific implementation modalities designed by the authorities, which consisted of the launch of pilot projects involving professionals in the field coming from different sectors in an iterative and incremental co-creation process. This choice caused new vertical interdependences to emerge between the levels of the health care system, transforming the roles of both the authorities and hands-on professionals involved; it also denoted a transition towards a more negotiated governance, in the course of which several types of knowledge and evidence have been mobilised.http://journals.openedition.org/irpp/1422pilot projectpolicy instrumentintegrated careknowledgepublic policy implementation
spellingShingle Mélanie De Winter
Reshaping health care governance using pilot projects as public policy implementation instruments
International Review of Public Policy
pilot project
policy instrument
integrated care
knowledge
public policy implementation
title Reshaping health care governance using pilot projects as public policy implementation instruments
title_full Reshaping health care governance using pilot projects as public policy implementation instruments
title_fullStr Reshaping health care governance using pilot projects as public policy implementation instruments
title_full_unstemmed Reshaping health care governance using pilot projects as public policy implementation instruments
title_short Reshaping health care governance using pilot projects as public policy implementation instruments
title_sort reshaping health care governance using pilot projects as public policy implementation instruments
topic pilot project
policy instrument
integrated care
knowledge
public policy implementation
url http://journals.openedition.org/irpp/1422
work_keys_str_mv AT melaniedewinter reshapinghealthcaregovernanceusingpilotprojectsaspublicpolicyimplementationinstruments