Working Atmosphere and The Role of Agency Influencing Collaborative Working between Health and Social Welfare Services -The Application of E-S Model to Two Pilot Projects-

보건복지협력에 영향을 미치는 업무환경과 실행자의 역할 - 두 시범사업에 대한 E-S모델의 적용 -

Despite the increase in the demands on collaboration between health and social welfare, the success of such schemes have been limited. The extant literatures tends to be dominated by explanations for needs or short-term outcomes of collaboration rather than systematic follow-up research to apply to the frontline. At the same time, there is no attempt to apply the theories related to collaboration in order to discuss the situation. This study explores the factors hindering such collaborative working in the frontline, through semi-structured interviews with practitioners involved in two pilot projects. A theoretical framework (Equilibrium Model-Sensemaking, E-S model) which combined Equilibrium Model of 'Interorganizational Network' of Benson(1975) and 'Sensmaking' of Weick(1995) for conceptualiing aspects of collaborations such as working atmosphere and agency was applied to the empirical study of the Public Health and Welfare Office(1995-1999) and the Social Welfare office(2004-2006) pilot projects. Data were collected over three months from 8 pilot project areas with practitioners and managers from health and social welfare. The findings show significant regional differences between pilot areas, such as the presence of active leaders and co-location, had a major impact on the ability of practitioners to effectively integrate services. In other words, active leaders tended to influence practitioners' motivation, while co-location encouraging communication between both practitioners, and thus seemed to influence the practices of collaborative working. Furthermore, through E-S model, it is interpreted that this kind of positive experiences about collaborations may impact on the current practitioners' comprehensive perspective towards health and social welfare services in general. The findings could help policy makers consider the practical ways to break down the barriers between health and social welfare.

본 연구는 사회구성주의 시각에서 보건복지사무소와 사회복지사무소에 참여한 직원들의 보건복지 협력경험을 벤슨의 균형모델(Benson, 1975)과 바이크의 센스메이킹 이론(Weick, 1995)으로 분석함으로써 업무환경과 실무자의 역할을 구상하는데 함의를 얻고자 함에 그 목적이 있다. 두 시범사업의 각 네 지역을 선정하여 총 27명의 직원을 대상으로 반구조화된 면접을 실시한 결과, 양 분야 실무자들이 통합서비스 업무를 담당할 수 있는 구조적 관계적 환경을 초기에 구성하여 직역간 벽을 허물 수 있는 계기를 마련하는 것이 중요하다는 것이 부각되었다. 이러한 연구결과는 향후 이용자 중심 사회서비스 설계에 있어 보건 복지간 협력이 보다 중요해지고 관련된 정책구상이 불가피하다는 점에서 시사하는 바가 클 것으로 본다.