For the past three years, Windsor Essex County Health Unit, in partnership with two family health teams, two nurse practitioner-led clinics and two community health centres, collaborated on developing evidence-based programs and services for their local communities, including a fluoride varnish pilot and a healthy eating program called Eat4Life.
In recognition of this great work, Windsor Essex County Health Unit was the 2017 recipient of the Association of Family Health Teams of Ontario’s (AFHTO) Bright Light Board of Directors Award for the category Leadership in Public Health and Primary Care Collaboration.
This is a special AFHTO award that recognizes an individual or organization who has significantly contributed to the development and growth of inter-professional team-based primary care within their local community or at the provincial level.
Health Quality Ontario had a chance to catch up with Nicole Dupuis, Director of Health Promotion at Windsor Essex County Health Unit, to gain a better understanding of how this partnership was formed, how it evolved, and the role of leadership in supporting and encouraging innovative quality improvement thinking.
The Windsor-Essex County Health Unit worked in partnership with six other agencies to develop a fluoride varnish program as well as the Eat4Life healthy eating program. What drew this partnership together?
A few years ago, there was a Primary Care and Public Health conference that created a heightened awareness about the value of partnerships and collaboration between these two sectors. This essentially planted a seed in our minds and created an environment conducive to partnering.
As a first step, the executive team from the Windsor Family Health Team (FHT) reached out to public health to express interest in working together. The Public Health Board had also initiated discussions with the senior leadership team regarding public health partnership with community stakeholders. So, when the Windsor FHT reached out the us, it fit really well with the strategic direction of the health unit.
The agencies we work with include:
- Windsor Family Health Team
- Windsor-Essex Community Health Centre
- City Centre Health Care-CMHA
- Harrow Health Centre Inc.: A Family Health Team
- Essex County Nurse Practitioner-Led Clinic
- VON Nurse Practitioner-Led Clinic Lakeshore
Members of the Windsor Essex team from left to right: Eric Nadalin, Manager of Chronic Disease, Mariel Munoz Tayraco, Public Health Nutritionist, Andy Langmuir, Web Specialist, Karen Bellemore, Public Health Nutritionist, Heather Nadon, Registered Dietitian, Nicole Dupuis, Director of Health Promotion. Presented with the Association of Family Health Teams of Ontario’s (AFHTO) Bright Light Board of Directors Award.
Were there any challenges in the initial forming stages?
As you can imagine, it is difficult to know where to start when thinking about tackling the many health priorities in a community. The biggest challenge was determining a focus for our partnership. We needed to find a starting point, something tangible to build from, which took considerable time and discussion.
One strategy that helped clarify our direction was first having each partner organization talk about their role in the community and what initiatives they were working on. Primary care may not know the role, mandate and scope of public health and vice versa. We spent time sharing information about our organizations, how we work, how we are funded, and what our strategic priorities are. Taking a few steps back to understand each other’s organizations was important.
We also collected an inventory of the community classes that we were each doing so we could see where there was overlap and opportunity. This really helped us to identify places that we might start to collaborate recognizing the opportunity to build on each other’s strengths and expertise. One source of duplication were healthy eating programs. Every organization was working on one with varying success. It was decided that collaborating on an evidence-based healthy eating program was a good place to start, and the Eat4Life program was the outcome of our efforts.
This first exploratory phase of our work took a year to sort through. It’s important to be prepared for this exploratory phase to take time.
What was the role of leadership in supporting and encouraging innovative quality improvement thinking?
Senior leaders with decision-making power to make real system-level change was essential to make our partnership a success. Leadership representatives from each agency continually came to the table over time. This ongoing commitment is quite rare.
Why was there such a high level of commitment from each of the agencies?
Many of the agencies we are working with started as new agencies within a 3-4 year period. They relied upon their relationship with one another as they became operational, so there was already a strong foundation of partnership and trust to build upon.
Our agencies all have similar mandates in terms of community health as well as an interest in community development. The fact that we are all community governed is what I think binds the relationship. It allows us to have more of an external focus without competing. There is an acknowledgement that we are stronger when we work together, and this can magnify our ability to have an impact. There was good recognition that we cannot solve large health issues on our own and that by working together we have a much better chance of being successful and addressing the community need.
Finally, when we first came together, we focused on very tangible and concrete projects. If we tried to solve a big nebulous issue, such as obesity, I’m not sure we would have gotten the same commitment. We focused our efforts on tangible projects where success could be measured.
What advice would you give an organization about creating successful partnerships?
I would say to reach out. That’s the biggest step. Another important step is to fully understand your partners by asking questions about their mandates, priorities and restrictions. By exploring these things, you create transparency, build trust and determine how you can help each other and help your community. Partner organizations also must be willing to give up the current way of doing things. Referring to your Terms of Reference to remind you why you are partnering really helps when you are heading down your new path.
What are your next steps?
Our group is working on a common health promotion calendar so that programs and services offered by our partner organizations will be hosted on the same website. It will provide people living in Windsor Essex with a coordinated point of access to programs and services open to the public.
Read more about Windsor-Essex County Health Unit on the AFHTO website.
Do you have questions about building and sustaining public health and primary care collaborations? Reach out to Nicole Dupuis, on Quorum.