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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