Supporting rural health services through regional networks: Observations of a formalized model

In many jurisdictions internationally, distributed networks of clinical care have emerged as a planning principle to meet the needs of rural communities. Such networks rely on productive relationships between small rural sites and larger regional centres as the mechanism for training and backup and as the pathways for transfer when triage to a higher level of care is required. This paper explores the impact of the Rural Surgical Obstetrical Network (RSON) initiative on regional relationships between networked sites in order to provide data on the efficacy of networked models of healthcare. Implementation of networked care may ultimately lead to better patient care. This qualitative study involved interviews and focus groups over 4 years with 169 rural healthcare workers and hospital administrators at different RSON sites. Data was analysed inductively using thematic analysis. Findings revealed three primary areas considered in the context of RSON funding: improved relationships (primarily through clinical coaching and the consequent building of reciprocal trust) and increased regional coordination of patient care through more efficient triage pathways and increased involvement of specialists through outreach care in rural communities. Continued lack of engagement with regional specialists was reported by a minority of participants. RSON provided a supportive infrastructure that benefitted both rural and regional services namely through funding for clinical coaching and quality improvement initiatives which enabled overall improved provider relationships between sites. This strengthened a regional approach to optimal patient care that should be supported on an ongoing basis.