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Table 3 Distinguishing statements for factor 3

From: Viewpoints about collaboration between primary care and public health in Canada

No.

Statement

 

Factor 1

Factor 2

Factor 3

13

We need to spend time making sure that both parties clearly understand the difference between the roles of primary care organization and the roles of the Public Health organization.

Interactional

0

1

5

40

Physicians, nurses and social workers are not sharing courses when they’re being educated; so they are not going to see the value of working collaboratively.

Systemic

−1

0

4

25

I think differing mandates are a barrier to collaboration. Public health can’t provide individual care because they are population health-based and group-based. For example public health is working on healthy food policies and trying to work with schools.

Organizational

−4

−2

3

6

Collaboration won’t work if people haven’t got the stable and sustainable funding to get it established, evaluated and carry it on.

Organizational

0

1

3

7

I think it is important in a collaboration that people use the skill set that they have. They do not always have to learn new skill sets, but utilize the skill sets that other people have.

Interactional

−1

−1

2

38

I think we need models like community health centres which are globally funded (salaried physicians who work in a team setting with a range of health professionals – nurses, nutritionists, social workers). So the more we move into this kind of model, primary care and public health collaborations might become richer.

Systemic

4

−1

1

3

It’s a lot about relationships and trust. People need to trust one another and know that everybody is working towards the same end. That will have the biggest impact on collaboration.

Interactional

5

5

1

34

We need to have a clear mandate from the top to enable public health, primary care and the rest of the health system to work together more effectively.

Systemic

5

−4

0

24

Public health is largely in a unionized environment and is a bigger, institutional culture. They’ve got much more prescribed practices around how they can deploy staff which is a big barrier to collaboration.

Organizational

−3

−2

0

33

I think the base unit of the health care system, just as WHO and everybody else around the world suggests, should be some sort of community health centre model which provides a primary care range of services practicing in the context of community.

Systemic

3

−2

0

2

I think physical co-location of primary care and public health results in increased exposure to one another and therefore a stronger understanding of each other’s skills and roles.

Organizational

3

1

−1

4

Partners need to consistently engage in dialogue to resolve issues. For example, they are working together identifying specific patients that both are involved with.

Interactional

1

3

−1

30

A facilitator for collaboration would be having a public health staff presence in a primary care setting—so there’s a face to public health. I can get information without having to go through a complicated process.

Organizational

1

1

−2

8

I think that people in different branches in the Ministry/ Ministries have to really believe in collaboration and support it enough so that they write policies that say these organizations are going to work together.

Systemic

4

0

−2

23

I think an important facilitator of collaboration is having a memorandum of understanding (MOU) of how we work together. For example, MOU says that each partner agrees to put X hours of service in on a weekly basis and we will have a planning day every year.

Organizational

−1

2

−3

17

We have evidence on the benefits of collaboration that are linked to long term health benefits for individuals in the population.

Systemic

−2

0

−4