Embracing complexity to optimize cross-sectoral collaborations for integrated care

Abstract

As healthcare is inherently complex and highly specialized, leaders often face challenges working across professional, organizational, and sectoral boundaries to achieve integrated care. This study aimed to better understand healthcare leaders’ perspectives on building cross-sector collaborations to support integration. Surveys and interviews were conducted with leaders from across the healthcare continuum, including hospitals, community support services, specialty communities, mental health, primary care, long-term care, and public health, who had been tasked by the Ministry of Health with collaborating across stakeholder groups. The application of Relational Coordination® surveys and key informant interviews revealed barriers to integration, including challenges with cross-boundary communication and inter-organizational relationships. The findings also identified several primers for integration to better inform next steps forward, including: (1) leadership and learning health systems, (2) trust and mutual respect, and (3) readiness to collaborate and build capacity. Ultimately, our findings suggest that structural and relational reform are equally important considerations affecting how policymakers can support further advancing integrated care.