Case Example

Case Study on Effective Communication

Primary care DoctorRegarding the collaboration, there was an initial roll out of the collaboration about 2 years ago.  I hear it worked really well.  Then it was rolled out to the general interdisciplinary primary care teams … and what happened was that we physicians didn’t know anything about it.”

The Setting
In an urban community with a population of over 250,000, public health was looking for ways to enhance their work with primary care practices in the area.

A public health supervisor spoke with the lead of a large primary care practice network with multiple satellite offices. They jointly decided to pursue a project to enhance the 18 month well-baby visit. Both sectors thought this topic was a good project to start with to form a collaboration since public health could offer resources and expertise to enhance primary care practice and it was identified as a need in primary care.

In addition, from the primary care practice perspective, they wanted to work more with community members and thought child health would be a good venue to pursue as a quality improvement initiative.

A formal agreement was drawn up by the leads of the organizations and a job description for a second public health nurse was established. The collaboration was set up on a pilot basis and then extended to other practices in the area. It was in the roll out to other sites and over time when problems emerged.

The Goal
The goal for this collaboration was to support enhanced 18 month well-baby visits in primary care.

The Players
Initially the players were the leaders of public health and primary care. Once the collaboration was being implemented at the front line, the key players involved were a public health nursing liaison, primary care nurses, and physicians. The public health nurse was seconded by primary care to work with primary care practices. She worked more directly with primary care nurses over physicians to provide education about the Rourke and Nippissing screening tools to enhance the 18 month well-baby visit. She shared a number of community and other resources to support this work as well.

Effective communication 
Effective communication is a frequently noted interpersonal factor that influences collaboration. Although there was effective communication initially at the organizational level, between public health and primary care and at the initial collaboration site, when the collaboration extended to more satellite offices and new staff joined the organization, there was a loss of effective communication at the interpersonal level.

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 Related: Strategic Coordination and Communication Mechanisms between Partners


Effective communication as a factor contributed to the success of primary care – public health collaboration for the enhanced 18 month well-baby visit.

Addressing the Communication Challenge

  • Employ a variety of communication strategies to reach all members of the collaboration team.
  • In this case, although the physicians were not as informed as they should have been, it was the primary care nurses and the public health nurse who worked together to meet the goals of the collaboration. All players should be informed about the aims and goals of the collaboration and activities being conducted even if they are not intimately involved. No surprise is a good surprise in this instance.

Key impacts of the collaboration

  • Increased consistency implementing the 18 month well-baby visit,
  • Improved thoroughness implementing the 18 month well-baby visit,
  • Increased parental satisfaction,
  • Increased primary care nurses competency and working to full scope of practice.

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