The Dutch Government is increasingly encouraging cooperation between local governments, health care, welfare and education, but little is known about factors leading to success of such partnerships. In the literature, the structural approach and the importance of trust are central themes in this context, but less focus is on the behavioral approach. In this dissertation, case studies are done of conditions and behavior that determine the success of these partnerships.
Regional nursing and care partnerships are discussed. Chapter 1 gives a reconstruction of policy in decision-making about these partnerships. The Ministry of OCW1 wanted to control the entire educational system and the institutions wished to continue their own vocational training; there used to be an underlying struggle for control. This underlying struggle influenced the decision-making and implementation process. The decision-making process changed from an educational system with only full-time education to a coherent system of education with both full-time education and day release courses (learning through a combination of going to school and working). The reconstruction policy mentioned above yields four empirical findings: 1. The government does not enforce policy on the organizations involved, but organizations form regional partnerships. These regions were expected to produce sufficient good internships and jobs for nursing and care. 2. The educational and care organizations in the regions had to take responsibility for good quantitative and qualitative education in nursing and care. 3. There are conflicting interests, self-interest versus general interest, between and within the members of the partnerships. 4. The form in which the partnerships could organize themselves was open. Against this background, the research question was formulated: “What are success factors in regional partnerships for nursing and care?”

8.2 Theoretical background (Chapter 2)
Chapter 2 describes how the research question was studied deductively. The theoretical insights, the shortcomings and the usability are discussed. Important insights were provided by theories about targeted networks, organization of networks, social capital and trust. Targeted networks had proven themselves as a form of coordination to achieve joint goals. In addition, the necessary insights were obtained on the organization and the administrative design of targeted networks. Also the importance of social capital for organizations in such networks and the importance of confidence offered important insights, such as the large availability of social capital for organizations if they knew how to use it. Trust did not always prove to be equally important or necessary for positive outcomes of cooperation. A high degree of mutual trust could lead to negative effects under certain circumstances, because the actors involved became less critical, and opinions were more directed towards each other than towards relevant developments outside the context of the network.
Little was known about how groups of employees of various organizations with opposing interests behaved within networks of similar organizations. Additionally, little empirical research was available about the relation between group behavior within the network. This was caused by methodological problems. It was difficult to examine the network as a unit of analysis and to formulate and study the success of the network as a dependent variable of the network.
By interpreting the regional nurse and care partnership as a ‘social situation’, it was possible to use more sociological approaches of networks, namely those of Weber, Coleman and Durkheim. A useful concept to understand a regional nurse and care partnership as a social situation is the approach of these sociologists: ”All structures are results of behavior” (Ultee, Flap & Arts, 2003).
The opposing interests of the members involved and the way in which they interact as a group should be examined in the partnerships. The Macro-Micro-Macro Model of Coleman (1990) offered connecting points to understand the behavior of the members in these circumstances.
The research question could be examined deductively by using the theory of reciprocity. Previous research showed that there are two fundamental forms of behavior: reciprocity and status behavior. The theory of reciprocity distinguishes multiple equilibria: free-rider behavior, intolerant, tolerant, and dedicated tolerant reciprocal behavior.

See dissertation for the complete summary.