Enablers

Enablers for governmental and regulatory policies and mandates are:

• Communicating an expectation that partnerships are essential,
• Requiring reporting on partnerships by Ministry of Health/Department of Health,
• Developing clear government policies, mandates, and laws that support collaboration,
• Reporting and measuring collaborations for accountability,
• Ensuring that accreditation criteria include a requirement for partnerships.

Partners are essential for joint action to achieve a common purpose.

Expectation that Partnerships are Essential
Provincial level managers need to create environments where building partnerships are promoted and supported. People in leadership roles are realizing that we need to work together. The big message, explains one public health ministry manager, is “We can’t be over here in our silo doing our own thing. That doesn’t work. We need to figure out how we could work together on planning, policy development, and issues.”

Why develop collaboration at the systemic level? It is the influence and power of a common voice that promotes the development of collaboration at a systemic level. Due to the complexity of issues faced by the Ministries of Health/Departments of Health at the systemic level, it is increasingly critical to work together to achieve the greatest outcome for the public. It’s better together than apart!

One primary care manager expresses his view on the importance of public health-primary care partnerships, “The motivation for the development of a collaboration is realizing that we can’t do this alone. In order to influence government, it takes a number of different people coming together with a common goal. When the collaboration is successful, it’s a win-win-win – for the partners, the people, and the government.”

Related: Formal Systems Leaders as Collaborative Champion

 Reporting on partnerships is required by Ministry
Ideally, there should be consistency of standards around collaboration for public health and primary care. Expectations should be clear and accountability for reporting on collaborations should incorporate common quality indicators.

Measuring the quality of partnerships is an important process in the implementation and sustainability of collaborative partnerships. As this provides clarity regarding the strengths and successes of collaboration, it also points to areas needing improvement. Expectations for accountability related to reporting on collaborations require the use of common quality indicators.

One Saskatchewan Ministry level representative explained the importance of the evidence of success based on outcomes resulting from the collaboration: “I think development, implementation, and evaluation are important because from the Ministry’s perspective we look for evaluation and evidence of success particularly in the context of efficiencies and health outcomes. Those two things make participants feel good about what they’re doing because then they know what each other is contributing. That really makes a difference in the successful outcome of the collaboration.”

Clear governmental policies, mandates, and laws that support collaboration
The value of having clear government policies and mandate for collaboration is a critical enabler to collaboration. The significance of this underlying support is recognized in the following remarks by a New Brunswick ministry-level government policy maker who stresses the importance of aligned policies for collaboration at provincial and local levels.

“There’s clearly lots of work to be done at a federal and provincial level. I don’t think that we’re going to be able to really effect change unless we have a unified agenda at all levels of government and in community.”

Reporting and Measuring Collaborations for Accountability
In terms of accountability frameworks and/or accreditation reviews, there are now higher expectations and greater opportunities for reporting and measuring collaborations. This is valuable information in couching the need and the value of partnerships and collaborations in health care services.

Accreditation requires partnerships
Accreditation Canada’s Standards for Public Health Services were prepared in response to a growing demand for excellence in Canadian health services, system-wide changes in structures for health care delivery, and the increasing need for public accountability. One primary care manager shares her views, “As I understand it, there is a growing public awareness now for collaboration as an essential part of health care services. It seems to be common knowledge that doing it alone isn’t the best way anymore.”

The Standards for Public Health Services address the five core functions of a public health system:

• Health assessment,
• Health surveillance,
• Health promotion,
• Health protection,
• Disease and injury prevention.

The approach taken to address these functions will differ according to each organization’s size, structure, and mandate. Access the full information on Accreditation Canada at http://www.accreditation.ca/.

Within each function is a subsection that includes: creating networks and mobilizing partners which, “addresses the processes needed to develop networks and partnerships to improve public health and to address the core public health functions.” Available from http://www.accreditation.ca/public-health-services.

An Ontario Ministry public health manager supports the new approach that considers the value and impact of partnerships: “We are starting to look at partnerships differently and we are even evaluating and not just measuring partnerships. Partnerships are appearing in strategic directions so we are evaluating not only the number of partners but what do partners say about the effectiveness of the partnership and the impact of the partnership.”