Table 2 Identified key factors for building structures for collaboration between family physicians and other healthcare sectors
From: Family physicians collaborating for health system integration: a scoping review
Factors | Enabling the structure of collaboration | Sources |
|---|---|---|
1. Shared vision, values, goals | ||
 Use a MOU to define common values and vision | Have MOUs and value statement, define shared identity and common values, compel a shared vision for change especially around potential benefits for patients, and respect multiple views, and ensure diverse viewpoints can be heard and appreciated | |
 Establish shared objectives and goals | Identify a common health or organizational goal that is unable to be achieved alone, allow collective goal-setting, and develop consensus on objectives Have common agenda, including a common understanding of the problems and a joint approach to solving it through agreed-upon actions | |
 Clarify mutual benefit from collaboration | Consider the benefits of working together instead of recruiting external help Leverage partnership to apply for funding | |
 Develop district health profile | Use data from public health, health centres, primary care, and municipality to develop district health profile to establish collective goals | [34] |
2. Collaborative Leadership | ||
 Build strong primary care physician leadership | Establish a physician group structure and develop communication channels within the group; build strong physician leadership that can support quality in primary care Set up professional committees, communities of practice | |
 Establish leadership with broad representation | Establish collaborative leadership (i.e., committees, boards), have broad participation and representation to facilitate joint planning, build relationships, guide and coordinate processes, systems thinking, and outcomes Establish steering committee that includes community members; related sectors (e.g., primary care, hospitals, etc.) send one or two members to higher level board so that each sector is represented and has a voice | |
 Use leadership to create clarity and foster trust | Create clarity: vision and mobilization; assess the environment Foster trust and good working relationships between collaboration partners, share power and influence Contribute to self-growth of group members and regularly engage in self-reflection | |
3. Collaborative decision-making | ||
 Develop a structure to guide and manage collaboration and anchor in primary care | Establish an appropriate management structure to execute the leadership team’s vision of the integrated care team. Have common guidelines for new models of collaboration. Use a 'linking organization' that connects actors per issue OHTs (Integrated care) should be anchored in primary care and build physician leadership. Formally plan and structure collaboration to guide interactions between physicians and specialists Identify appropriate change management tools and resources required to facilitate collaboration across partner organizations | |
 Free up resources to be shared among collaboration partners | Free up resources to be shared across your system, share project resources, use shared EMR and appointment system, and keep transparency about cost | |
 Formalize communication mechanisms; increase transparency | Formalize agreements and regular meetings, have more structured communication such as shared electronic patient records, use common language, use an effective information sharing technique, have regular inter-organizational knowledge sharing Keep the patient voice respected | |
 Manage organizational stability | Develop methods to support network coherence and stability, facilitate relationships through pairing of partners | |
Develop shared decision- making agreement | Develop a governance model or framework for a transparent and constructive approach for decision-making that allow members to hold each other accountable Collaborative decision-making agreements need to describe performance management, information management and sharing, resource allocation, conflict resolution, and the extent to which new members can be accommodated | |