ArticleBMJ open2022
How the Esther Network model for coproduction of person-centred health and social care was adopted and adapted in Singapore: a realist evaluation.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Trailblazing Person-Centred Care: Lessons From a Hospital Cluster-Wide Retreat to Co-Design Approaches to Person-Centred Care in Singapore.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Attachment-informed mental healthcare systems as 'organisational caregivers': ideas for the future.BJPsych bulletin · 2025Article
- Health and Social Care Integration: Insights from International Implementation Cases.Journal of market access & health policy · 2025Article
- Expanding the role of community hospitals to promote population health in Singapore.The Lancet regional health. Western Pacific · 2025Review
- An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes.International journal of integrated careArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe Esther Network (EN) model, a person-centred care innovation in Sweden, was adopted in Singapore to promote person-centredness and improve integration between health and social care practitioners. This realist evaluation aimed to explain its adoption and adaptation in Singapore.
designAn organisational case study using a realist evaluation approach drawing on Greenhalgh
settingSingHealth, a healthcare cluster serving a population of 1.37 million residents in Eastern Singapore.
participantsPolicy makers (n=4), EN programme implementers (n=3), practitioners (n=6) and service users (n=7) participated in individual interviews or focus group discussions. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome data from healthcare institutions (n=13) and community agencies (n=59) were included in document analysis.
resultsSingapore's ageing population and need to transition from a hospital-based model to a more sustainable community-based model provided an opportunity for change. The personalised nature and logic of the EN model resonated with leaders and led to collective adoption. Embedded cultural influences such as the need for order and hierarchical structures were both barriers to, and facilitators of, change. Coproduction between service users and practitioners in making care improvements deepened the relationships and commitments that held the network together.
conclusionsThe enabling role of leaders (macrosystem level), the bridging role of practitioners (mesosystem level) and the unifying role of service users (microsystem level) all contributed to EN's success in Singapore. Understanding these roles helps us understand how staff at various levels can contribute to the adoption and adaptation of EN and similar complex innovations systemwide.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.