背景:使各个部门的交付和融资系统保持一致,以创建更广泛的护理系统,可以改善经历逆境的家庭的健康和福祉。我们旨在确定最佳实践的结构和关系因素,以实现美国家访计划之间的成功跨部门合作。
方法:我们使用了多案例研究方法来确定最佳实践,以便在家庭访客和其他社区服务提供商之间进行成功的跨部门合作。我们选择了五个不同的示例案例,这些案例具有跨部门合作,执行机构类型和地理位置各不相同。基于与先前调查数据中确定的不同社区服务提供商类型的强大协调和整合,使用积极偏差方法选择了案例。我们对家访人员进行了深入的定性访谈,社区提供者,和客户,从2021年到2022年共进行了76次采访。我们写了备忘录,通过使用访谈数据的数据三角测量来综合每个案例中的主题,文件,和现场访问观察。我们比较了五个案例的主题,以创建成功的跨部门合作的最佳实践的跨案例综合。
结果:在五个案例中,关系因素,包括各级领导,各行各业的冠军,社区提供者之间的共同目标是成功合作的关键因素。人际关系,再加上参与的愿望和能力,促进有效协调,以满足家庭需求。在结构层面,共享数据系统,书面协议,并在同一地点进行了护理协调活动。社区顾问委员会为发展伙伴关系提供了场所,关系建设,资源共享,和提高家访意识。
结论:我们在五个案例研究中确定了成功的跨部门合作的关键要素,其中家庭访客经常协调护理和/或与一系列提供商在结构上整合。这些学习将为未来的干预措施提供信息,以改善与其他社区提供者的家访合作,以创建一个护理系统,以增强家庭幸福。
BACKGROUND: Aligning delivery and financing systems across sectors to create broader systems of care can improve the health and well-being of families experiencing adversities. We aimed to identify structural and relational factors for best practices to achieve successful cross-sector collaboration among home visiting programs in the United States.
METHODS: We used a multiple case study approach to identify best practices for successful cross-sector collaboration between home visitors and other community service providers. We selected five diverse exemplary cases with cross-sector collaboration with variation in implementing agency type and geographic location. Cases were selected using a positive deviance approach based on strong coordination and integration with different community service provider types identified from previous survey data. We conducted in-depth qualitative interviews with home visiting staff, community providers, and clients with a total of 76 interviews conducted from 2021 to 2022. We wrote memos to synthesize themes within each case through data triangulation using interview data, documents, and site visit observations. We compared themes across the five cases to create a cross-case synthesis of best practices for successful cross-sector collaboration.
RESULTS: Across the five cases, relational factors including leadership from all levels, champions across sectors, and shared goals between community providers were key factors for successful collaboration. Interpersonal relationships, coupled with the desire and capacity to engage, facilitated effective coordination to address families\' needs. At the structural level, shared data systems, written agreements, and co-location enabled care coordination activities. Community Advisory Boards provided a venue for developing partnerships, relationship-building, resource-sharing, and increasing awareness of home visiting.
CONCLUSIONS: We identified key elements of successful cross-sector collaboration across five case studies where home visitors coordinate care frequently and/or are structurally integrated with a range of providers. These learnings will inform future interventions to improve home visiting collaboration with other community providers to create a system of care to enhance family well-being.