'Misfit' and 'jack of all trades': A qualitative exploration of the structure and functions of a network administrative organisation in Ontario, Canada.

ObjectivesLarger, more complex inter-organisational networks with strong, centralised governance structures, often in the form of a network administrative organisation (NAO), have developed in recent years in response to wicked health and social problems. Set in Ontario, Canada, this study explored how NAOs and networks are structured, how they function, and how they evolve.MethodsWe conducted a case study of a NAO and network consisting of 40 member networks in the province of Ontario, Canada. We analysed secondary sources, including policy documents, legislation, contracts, websites, and existing qualitative data.ResultsThe NAO and member networks developed in tandem and dialectically. They ultimately took on a form that defies categorisation within the existing literature due to their structure as a 'network of member networks' and by acting simultaneously as a policy network, service delivery coordination network, and governance network, by executing numerous complex mandates and functions in service of multiple stakeholders, and by exemplifying both high control and high collaboration.ConclusionsWe classified the NAO and its network as a 'misfit' and 'jack of all trades'. These features may help explain its perceived effectiveness. The complexity and hybrid nature of the NAO and network may position it to best address multifaceted health care problems.