142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Managing unintended consequences of inter-agency collaboration

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 12:30 PM - 12:50 PM

Nidhi Khosla, PhD, MPH , Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
Background: Inter-professional collaboration among agencies offering diverse services and employing professionals from different disciplines is advocated in order to serve clients needs holistically. However, collaborations may face unanticipated challenges and have unintended effects.

Methods: Data was collected in Baltimore, Maryland over late 2010-early 2012. The purposive sample comprised twenty-one agencies including medical providers, CBOs and local health department units that served HIV positive people. Twenty-three key informant interviews were conducted about inter-agency collaboration. A thematic analysis was done.

Results: Many agencies believed that inter-professional collaboration helped agencies to serve clients’ needs comprehensively. However, some also reported unwelcome consequences. In one instance, social work staff at an agency faced tensions in working with a peer-led intervention that maintained loose boundaries with clients. Another termed its partnership a “dictatorship” and ended it. In another instance, an agency that was short-staffed was obligated to share its staff with a partner agency due to an agreement that had not been carefully framed. In another case, an agency’s reputation was affected due to alleged irregularities by a partner. These agencies now assess potential collaborators more closely before establishing partnerships. Agencies also seek to reduce the likelihood of such experiences by collaborating only with known partners or adding more in-house services.

Conclusions: Inter-professional or inter-agency collaboration has many benefits but can backfire. Agencies can reduce the likelihood of negative experiences by clearly identifying the objectives and shared responsibilities ahead of time. Paying more attention to partner selection may also help reduce the likelihood of adverse consequences.

Learning Areas:

Administration, management, leadership
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify challenges that might arise during interprofessional collaboration Explain strategies that agencies have used to prevent such challenges from occurring again

Keyword(s): Community-Based Partnership & Collaboration, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied and published about factors that affect collaboration among agencies that provide health and human services to vulnerable populations such as people infected by or at risk of HIV in the US. I have also been engaged in grant writing, program implementation and monitoring of collaborative community based projects and alliances on health and poverty alleviation for over 5 years in India and Bangladesh.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.