Table 3.
Distinguishing statements for factor 3
| 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 |