Success Factors

Factors that Contribute to a Successful Cross-jurisdictional Sharing Agreement

Public health departments face limited budgets and personnel resources, challenging their ability to protect the health of the communities they serve. Cross-jurisdictional sharing is beneficial for health departments that believe by working together – pooling resources, sharing staff, expertise, funds and programs – across boundaries, they can accomplish more than they could do alone. That is the benefit of cross-jurisdictional sharing (CJS). 

There are many kinds of CJS arrangements, from simple handshake agreements to full-scale consolidation or mergers of health departments. Throughout this wide spectrum of arrangements, there are several factors that can increase the likelihood that a CJS arrangement will be successful.

We have divided these success factors into:

  • prerequisites,
  • facilitating factors, and
  • project characteristics.

Prerequisites

The following factors should be in place before partners start to work on a sharing arrangement. If any are missing, we recommend that partners spend some time addressing them before a CJS initiative actually starts.

Clarify Your Objectives

All participants need to explicitly state what their expectations are for the CJS initiative and be in agreement about what the CJS arrangement will accomplish. Equally important is understanding what is “off the table” in the sharing arrangement. Once objectives are determined and confirmed, it is important to review them often with all stakeholders in order to verify that they are still valid and to avoid misunderstandings, hurt feelings and damaged relationships.

Balanced Approach

Improved effectiveness (i.e., enhancing existing services or adding new ones) and increased efficiency (i.e., maximizing the value of each dollar invested) do not have to be mutually exclusive. The most successful CJS arrangements strive to achieve the best results with the amount of money available. An excessive, unbalanced focus on one of these two elements is likely to compromise the other.

Build Trust

Trust is essential in all CJS arrangements and needs to start at the top and percolate down. Partners in a CJS agreement must be confident that the other parties involved will make honest, good-faith efforts to achieve the common goals that were agreed upon. A successful outcome is dependent, in part, on the behavior and reliability of everyone involved. Trust is built slowly but can be lost swiftly. It is important, therefore, to consider the existing trust level between the organizations and stakeholders involved when determining the feasibility of a sharing arrangement. A tool to measure the existing trust level among partner organizations can be found here [LINK to whatever this new link is: https://phsharing.org/2015/03/20/cross-jurisdictional-sharing-agreements-collaborative-trust-scale/].

Facilitating Factors

There are three factors that facilitate a CJS arrangement. While the presence of these qualities is positive, their absence does not mean a CJS arrangement will fail.

Success in Prior Collaborations

Jurisdictions that have successfully worked together in the past may find it easier to work together on new CJS initiatives. It often takes time for group members to trust each other and to learn how to be productive when working together. If there is anxiety among stakeholders about the initiative, pointing out success in prior collaborations and understanding what may be different in the new effort can help to diffuse the anxiety. These two resources can help do that:

LINK TO NEW VERSIONS OF:

https://phsharing.org/2015/03/20/9332/ 

https://phsharing.org/2015/03/20/assessment-tool-for-public-health-existing-services/ 

Sense of Regional Identity

A sense of regional identity can be a powerful foundation for CJS arrangements. Stakeholders from an area with a regional identity are more likely to express sentiments such as “We’re all in this together” and “We need to help each other out.”

Positive Interpersonal Relationships

Positive interpersonal relationships, especially among those negotiating, can help to facilitate a CJS initiative. People who like each other and have a positive working history together are more likely to work well together in a new CJS initiative. They also may be more willing to compromise in order to craft an arrangement that is mutually beneficial to all communities involved. It is important to involve in the sharing initiative staff who are known for having good “people skills” and are likely to get along with their counterparts from other organizations.

Project Characteristics

The following project characteristics can help a CJS arrangement succeed. Partners in a CJS initiative should ensure that these elements are addressed in the project plan and implementation.

Senior-level Support

CJS initiatives have important implications on functions, services and capacity. Therefore, it is imperative that all CJS initiatives have the support of senior-level administrators and policymakers from all jurisdictions. They also should express clearly that the CJS initiative is a priority for them and that they expect everyone in their agency to work toward its success.

Strong Project Management Skills

CJS initiatives are often complex projects with lots of moving parts. The people on the CJS team often have full-time duties in addition to their CJS work. Staying organized and on track can present challenges, especially when several organizations are working together on the initiative. A strong project management plan is essential to assure that all the planned activities are implemented successfully and smoothly.

Strong Change Management Plans

CJS initiatives always involve change, which can come in many forms and can affect both the organizations and the individuals involved. For example, policies and procedures can change as can governance and staff responsibilities. People may have concerns while they try to anticipate what is ahead of them. Deliberately tending to change and its effect on staff and stakeholders is an important component of change management, and it requires the presence of good communication and meaningful engagement of all employees and stakeholders.

Effective Communication

Communication plays a vital role in any undertaking, especially those involving change. A well-developed communications plan dealing with the shared services is  recommended in CJS efforts. This plan should specify who the target audiences are, what messages should be delivered to them, and which organization or individual is responsible for communicating about the initiative. Communications activities should target both internal stakeholders directly involved in the CJS effort and external partners who can be affected by the initiative.

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