Partnering for Implementation: The Need to Place Partnering More Centrally in Our Implementation Planning and Evaluation Efforts
By Dr. Sobia Khan, Director of Implementation
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So much of the work we do in implementation relies on partnering with other people or organizations, and often across sectors and systems, in order to be able to meet our implementation goals. Partnerships have long been considered a structural piece required to understand the administrative aspect of implementation. We are coming to realize that understanding the relationships between actors in a system (i.e., people, organizations, sectors) is actually a much more important piece that we need to pay attention to when implementing.
Why is understanding partnering so important?
Whether you're working in research or practice, many of you have likely been part of some sort of partnership. Those of you who are working in systems often have to partner with others as part of your job for different reasons, whether it is securing funding, planning and implementing new programs, launching an evaluation of existing programs, etc. Working with others is an essential part of what most of us do. However, when we think about what works and doesn't work in implementation, we relegate partnering to the “lessons learned” sections of our reports and papers. If I had a dollar for every time I read that about the relational aspects of partnerships as a passing comment in the discussion section of a paper, I would be a very rich woman. This tells us that if partnerships are indeed that important to implementation, perhaps we should be considering them more seriously and a lot earlier in our planning and implementation efforts. We should also be thinking about how we might evaluate partnerships as an implementation process, so that we can better understand what levels and quality of partnering are required in order to be able to meet our implementation goals. This will help us implement better, and can also help us better understand the “necessary conditions” for scaling up.
3 ways to approach partnering differently
I have spent a long time understanding relationships between organizations and within systems as part of my doctoral work. What I have learned is that we have a rich history in the business and social sciences literature - in fact, decades of research - about the nature of interorganizational relationships that includes governance structures, overall network structures, and relational processes. What I saw in the implementation science literature was that most of these relational factors were largely excluded. While some frameworks [like the Consolidated Framework for Implementation Research and Exploration, Preparation, Implementation and Sustainment (EPIS)] include some mention of connections or relationships between different system actors, the field has an opportunity to use what we already know from other fields to parse out what these partnering processes and factors actually are. I myself am currently developing an evaluation framework that connects partnering processes to implementation goals to fill a gap in the field. Here is some practical advice that I developed based on this work, and that I often give to others:
What are the contextual and partnership factors that you can consider?
Implementation is not just about the intervention, but also about other factors like context and partnerships. I frequently tell people about the “layers” of implementation – think about partnering as a “foundational layer” that needs to be set to build effective structures (interventions) on top of it.What are your partnering goals and objectives?
When you think about partnering in this way, then it makes sense to include partnering more explicitly in your implementation plan. How are you going to build an effective foundation? This means that in addition to developing implementation objectives, it helps to also set partnering goals that align with those objectives.Essentially, WHO is involved in implementation and HOW are they are interacting to make implementation happen? Articulating this in a plan helps to clearly articulate the purpose of a partnership, which further helps develop a shared agenda and common understanding of that agenda (these are key ingredients of an effective partnership).
What are the barriers and facilitators to partnering?
Since partnering is another layer of implementation, then we can approach it in the same way we approach other layers of implementation (like context or the intervention itself) - we should aim to understand the barriers and facilitators to partnering, and select partnering strategies that help to overcome barriers and leverage facilitators.
Others in the implementation field are also thinking very deeply about partnering and how it might be better evaluated. For example, Alicia Bunger and her team have done much work on understanding relational and collaborative strategies. We have asked their team to describe their project and highlight collaborative strategies in this month's bulletin. A note about terminology – I chose to use the term “partnering” because “collaboration” can be characterized as a very intense level of partnering (meaning, there are different intensities of partnering you can engage in, and collaboration is a special level/intensity). However, others sometimes use these terms are synonymous terms, and in this bulletin, partnering strategies and collaborative strategies essentially mean the same thing.
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