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Frontiers in Public Health Services and Systems Research

An RWJF Collection

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Preliminary Findings from an Interventional Study using Network Analysis to Support Management in

The Children's Medical Services, at Broward General Medical Center, in Ft. Lauderdale, Florida, focuses on children with special needs.

Management is the core service that integrates and coordinates essential public health services.

The Issue:

Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management.

These researchers conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. They deployed a standard survey to collect organizational network measurements pre- and post-intervention. They presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization.

Key Finding:

Post-intervention they found unexpected, significantly higher network centralization in daily work. They attributed this increase in hierarchical communication to preparations for a statewide accreditation initiative.


When QI initiatives are undertaken globally within a state, managers and leaders need to be alert for possible impact on autonomous decision-making of professionals at the point of service which could affect service delivery.