Challenges
There are a number of health services structures that can act as challenges to collaboration including:
- Lack of a linked provincial database and information technology at provincial level,
- Lack of attention to collaboration in existing practice guidelines,
- Public health and primary care work in siloed Ministries,
- Pessimism that collaboration between public health and primary care is possible.
Lack of a Linked Provincial Database and Information Technology at the Provincial/Territorial Level
Many of the challenges related to this factor have to do with lack of access to data at the systems level. Although some provinces do have a linked provincial database that can be accessed by practitioners, several provinces do not yet have this infrastructure available. Practitioners have experienced frustration by not having access to such databases. There is a need for strong advocacy to encourage the development of linked databases at the provincial/territorial level.
Related: Harmonized Information and Communication Infrastructure
Lack of attention to collaboration in existing practice guidelines
Despite the importance of best practice guidelines and evidence reviews in supporting collaboration and their relevance to both public health and primary care practitioners, they do not specifically provide guidance on how to initiate, develop and sustain effective collaborations.
Furthermore, there are no practice guidelines available that relate specifically to supporting collaboration. Development of such guidelines to facilitate collaboration on a variety of health issues could be very helpful. This toolkit offers some of this support.
Public Health and Primary Care Work in Silos
Many people have pointed out that public health and primary care often work in their own silos, with few mechanisms to bridge them. Very different systems of care, with different structures, a different organization, and different funding mechanisms create silos that are difficult to transcend. An important strategy to bridge those silos involves government leadership in creating opportunities for public health and primary care to transcend silos.
Public health and primary care professionals share their perspectives on the challenges.
Pessimism that Collaboration between public health and primary care is possible.
Research has found that there is a general sense of pessimism among many that collaboration can actually take place because of differences between the two sectors in terms of their values and beliefs, their mission and mandates, and their training and education. (Valaitis et al., 2012) See http://fhs.mcmaster.ca/nursing/documents/eco-reportFINAL.pdf.
This does create challenges for people to work together at any level of the system. However, this pessimism is not universal because many positive examples are available and many people also have had positive experiences.
Related: Personal Values, Beliefs and Attitudes
Related: Shared Values, Beliefs and Attitudes