Enablers

Clear mandates, vision, and goals for collaboration are fostered when:

• There is buy-in (acceptance) or understanding of collaboration,
• Formal agreements have been established,
• Primary care & public health have a congruent focus.

Clear mandates, vision, and goals for collaboration are fostered when there is buy- in and/or understanding of collaboration at all levels in the organizations. This is further enhanced by the contribution of resources to facilitate collaboration.

To get buy-in, communicate the vision and benefits of collaboration to all parties, including the patients/population you are serving.

Make clear the added value for everyone involved and show where you can get a ‘win-win’ for both sectors. This is particularly important when you are working to overcome conflicting foci of each sector.

Ensure that primary care physicians who are key gatekeepers are involved and on board. Communicate collaborative services to the public that you are serving to also gain their buy-in.

Bottom line — you need to sell collaboration!

Bridge the two universes to highlight mutual benefits for each sector’s investment – such as: Communicable disease control, chronic disease prevention, health promotion, and outreach for hard to reach populations. Collaboration needs to have appeal!

A significant starting point for collaboration is having a formal agreement that clearly delineates roles and responsibilities as well as mutual goals for the collaboration.

Some examples include:

• Formal contractual agreements, such as a Memorandum of Understanding (MOU);
• A written operational plan that promotes cross-sectoral planning, coordination, and implementation;
• Developed strategic plans, goals, and terms of reference;
• Policies related to privacy issues, electronic record systems, IT systems, and data responsibilities and accountabilities.

One public health nurse cautions: “Acceptance of formal agreements depends on the culture and world views of the community; for example, working with some aboriginal groups or some immigrant groups would require a long process of relationship and trust building before acceptance of even the idea of developing a MOU as this may be contrary to their values and beliefs.”

Related: Strategic Coordination and Communication Mechanisms between Partners
Related: Trusting and Inclusive Relationships 

Additionally, when primary care and public health have a congruent focus, a collaboration is more likely to thrive. This could mean that both primary care and public health have shared philosophies and approaches, and/or a similar focus on protection, prevention, promotion, and/or a population health approach that addresses determinants of health.

Messages communicated about the collaboration need to be meaningful for both audiences and address the philosophies of both sectors. This administrator points out some philosophical differences.

“In well functioning health authorities you are getting the whole organization focused on population health goals. Some ways of achieving those goals will be through better care for individuals.

In some cases it will mean working on traditional public health programs, and in some cases, it is about conducting innovative projects that you can do when you have public health and primary care together that address both strategies.“

Negotiate clear roles and expectations of each sector upfront. Don’t forget to communicate these and make clear how activities relate to goals of the collaboration. Ensure job descriptions include each staff members’ activities in relation to the collaboration and be prepared to make adjustments as the collaboration matures and evolves.