Cross-domain collaboration. Lessons learned from three different communities in the Netherlands

Abstract

Introduction: Primary care in the Netherlands faces major challenges. Health problems are becoming more complex and care is preferably provided in one's own environment. Application of the concept of Positive Health reveals that non-medical care is sometimes the better option. The aim is for people to be self-reliant, if required in collaboration with informal caregivers or applicable citizen initiatives. We call it collaborative self-reliance. These challenges require reorganization towards a health care system in which citizens, health- and welfare professionals and policy makers collaborate. However, the development of such collaboration is context specific and challenging.
 Aim and Methods: We applied participative action research to identify success factors and barriers to develop cross-domain collaborations in care and support networks, including healthcare and welfare professionals and citizens. Three different communities in the south-east part of the Netherlands were included, a small rural village, a medium sized village and a multicultural city district. Researchers joined the three communities to closely follow the developments and provide support from September 2021 to November 2022. Data were collected through document analysis, observation and interviews. Our approach was informed by community development theory. Interviews were thematically analysed using the qualitative analysis software Atlas.ti.
 Results: Preliminary results revealed several important points of attention. As regards their collaboration, networks should formulate an ambition but also concrete objectives. Because the energy is in the action, the group must prevent it from becoming a discussion group only without taking concrete action to achieve its objectives. Nevertheless, regular meetings are necessary for continuation towards the objectives of the network. For the change process, next to a driving force, a liaison is important to facilitate cross domain collaboration. Knowledge and skills in change management improves the efficiency of the process. Furthermore, it is important to consider the ecological level that the network intends or needs to influence to reach your goal. To involve citizens, a sense of community is a prerequisite. In general, successful networks are not discouraged by not achieving a goal, they reflect and persevere. Final results will be presented during the conference.
 Conclusion: The development of care- and support-networks is a complex and lengthy process in which various barriers need to be overcome. Consequently, it requires commitment and perseverance of all participants. A driving force and liaison are important to keep the process going. Making sound collaboration agreements is valuable for sustainable collaboration.
 Implications: It is recommended to be aware of the socio-ecological level on which the network operates. Networks need to identify concrete objectives and invest in commitment of stakeholders to facilitate sustainable collaboration. It is relevant to identify quick wins at the start in order to conserve the energy and commitment of the group.