Problems of integrated palliative care: a Dutch case study of routines and cooperation in the region of Arnhem.

Cooperation in networks of providers of palliative care in Europe is problematic. Based on the concept of routines (patterns of behavior) and data about a Dutch network, we developed an explanation of this problem, in order to better understand the conditions for cooperation. Although more research is needed, the study suggests that disparate matches (divergence) between routines of the network members hampers cooperation. To promote cooperation, divergence, and legislation that stabilizes existing routines, must be identified. Divergence must be overcome and negotiations and transformational leadership, which require power sources, may be useful for this.