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Table 5 Features of successful clinical networks – facilitators and barriers

From: The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies

Facilitators of network success Barriers to network success
Sufficient resources – funding, administration and human (staffing) Availability of information and communication technologies A bottom-up, locally-initiated and driven approach to network implementation, with subsequent formalisation to increase the adoption of new processes A positive, trusting culture where networks are seen as desirable and perceived to be necessary to sharing knowledge, and where there is open and inclusive communication, clinician engagement and widespread genuine stakeholder participation The norms and values of the network are compatible with those of the organisations involved Strong leadership, particularly by clinical leaders and network managers using a facilitative approach Inclusive membership in the network, including representation of patients and other stakeholders Engagement at different levels of the healthcare system Evidence based work plans and projects that address issues identified by network members, particularly gaps in current practice, with goals that are feasible and can be objectively measured Supportive policy environments and links with government agencies Lack of funding and resources Tension, distrust and competition (particularly over resources) between network members An imbalance of power between network members resulting in competition for resources Poor communication and unwillingness to collaborate Lack of confidence in the ability of network leaders and managers Lack of representation of key stakeholders in certain contexts (e.g. rural and indigenous interests) Poor record keeping and documentation, which made it difficult to measure the impact of network initiatives and track progress A top-down approach of network implementation, or where implementation is mandated, led by external organisations, and/or decision-making powers and responsibilities are maintained by external parties thereby limiting the powers of network members