Modern public health
emphasizes population-focused services, which may require collaborative work both across and within organizations. Studies have explored interorganizational collaborations, but there are little data regarding collaborations within public health
We measured intraorganizational collaboration and identified barriers and facilitators to collaboration within a large public health
department through a mixed-methods study.
Our study occurred at the Maricopa County (Arizona) Department of Public Health
, the third largest local public health
jurisdiction in the United States. To measure collaboration, we surveyed staff using the relational coordination
tool. To identify barriers and facilitators to collaboration, we performed key informant interviews with department personnel.
Results: Relational coordination
scores varied according to the focus of the service; clinical services had significantly lower levels of relational coordination
than population-focused services (p
< .01). We found high levels of mutual respect and lower levels of shared knowledge across services. Facilitators to collaboration included purposive cross-program meetings around specific topics, the organization’s structure and culture, and individuals’ social identities. Barriers included raised expectations for collaboration, low slack resources, member’s self-interest, and trust.
The relational coordination
of services varied significantly according to the focus of the service. Population-focused public health
services had higher levels of relational coordination
than individually focused services. Collaboration was facilitated and impeded by both well-known and potentially emergent factors, such as purposive cross-service meetings and organizational culture.
Population-focused services possessed higher levels of collaboration than individually focused services. Intraorganizational collaboration for improved population health
relies on deliberate support from senior management and structured activities to increase shared knowledge and mutual respect.