TY - JOUR
T1 - Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families
T2 - a qualitative study of provider perspectives
AU - Green, Anna
AU - Abbott, Penelope
AU - Luckett, Tim
AU - Davidson, Patricia Mary
AU - Delaney, John
AU - Delaney, Patricia
AU - Gunasekera, Hasantha
AU - DiGiacomo, Michelle
N1 - Funding Information:
This work was supported by an Australian Research Council Linkage Project grant LP120200484. AG was a PhD student supported by LP120200484. Providers identified that variable and inconsistent funding impeded collaboration. Government funding perceived as not well planned impeded the ability of services to plan for the future. Funding structures aimed at increasing competition for the same pool of funding was also identified as impeding providers working together due to competition motivated by self-interest. It had impact at the interactional level by providing an incentive for services not to refer to other services to protect caseload targets. “ Collaboration’s dead in the water … C ollaboration doesn’t exist now because of that absolute vicious seeking of dollars and so many services irresponsibly applying for a grant, getting the bucks because they’re a big organization … and then trying to work out how to do it.” (education provider) Providers also identified that funding requirements needed to be flexible in recognizing that working with Aboriginal providers and services within the community takes time, and therefore adequate funding was needed to support the relationship-building phase. This was particularly relevant for services that were new to a geographic area. Some providers identified that the government should be actively assisting providers to work together at the level of service provision, and not just relying on policy to drive collaborative service provision to Aboriginal children with a disability. This could include funding being linked to evidence of collaborative practice, whereby government integrated strategies to promote providers working together into funding requirements. One suggestion was that services be required to demonstrate how they had worked with other services as a pre-requisite for funding. “It should be almost before we give you this bucket of money, you have to connect with every agency … so that’s every early intervention service in your area … we want three meetings, not just one token go and have a sandwich and a cup of tea, where you’re all talking and you work out who overlaps.” (education provider) The authors wish to acknowledge the providers who participated in this study. We greatly appreciate their willingness to share their stories.
Publisher Copyright:
© 2019, © 2019 Taylor & Francis Group, LLC.
PY - 2020/5/3
Y1 - 2020/5/3
N2 - Aboriginal and Torres Strait Islander children experience a higher prevalence of disability than other Australian children. Early intervention from across the health, education, and social service sectors is vital for improving outcomes, but families face lack of coordination between services. This study aimed to inform improvements in service access for families of urban-dwelling Aboriginal children with disability through exploring providers’ perceptions of factors that influenced working together across sectors. Semi-structured interviews were conducted. Data analysis was informed by the general inductive approach and the Collaborative Practice to Enhance Patient Care Outcomes framework. Twenty-four providers participated. Interprofessional collaborative practice was influenced by interdependent interactional and organizational factors. Interactional factors fit within one of two dimensions: the ability of providers to share common goals and vision within a complex cross-sector service landscape, and influence of interpersonal relationships on their sense of belonging working in a cross-cultural space. Organizational factors also fit within one of two dimensions: the influence of governance in relation to its role in coordination and unlocking the strength of schools as service settings, and the need to formalize processes for effective interprofessional communication. Interprofessional collaborative practice was managed within the context of systemic factors relating to policy and funding. These findings demonstrate the complex interplay of factors related to the cross-sector involvement of providers in early intervention service provision. Consideration of these factors is required to facilitate collaborative cross-sector responses to improve service access for Aboriginal families. Abbreviations: WHO: world health organization; ACCHS: aboriginal community controlled health service; GP: general practitioner; NDIS: national disability insurance scheme.
AB - Aboriginal and Torres Strait Islander children experience a higher prevalence of disability than other Australian children. Early intervention from across the health, education, and social service sectors is vital for improving outcomes, but families face lack of coordination between services. This study aimed to inform improvements in service access for families of urban-dwelling Aboriginal children with disability through exploring providers’ perceptions of factors that influenced working together across sectors. Semi-structured interviews were conducted. Data analysis was informed by the general inductive approach and the Collaborative Practice to Enhance Patient Care Outcomes framework. Twenty-four providers participated. Interprofessional collaborative practice was influenced by interdependent interactional and organizational factors. Interactional factors fit within one of two dimensions: the ability of providers to share common goals and vision within a complex cross-sector service landscape, and influence of interpersonal relationships on their sense of belonging working in a cross-cultural space. Organizational factors also fit within one of two dimensions: the influence of governance in relation to its role in coordination and unlocking the strength of schools as service settings, and the need to formalize processes for effective interprofessional communication. Interprofessional collaborative practice was managed within the context of systemic factors relating to policy and funding. These findings demonstrate the complex interplay of factors related to the cross-sector involvement of providers in early intervention service provision. Consideration of these factors is required to facilitate collaborative cross-sector responses to improve service access for Aboriginal families. Abbreviations: WHO: world health organization; ACCHS: aboriginal community controlled health service; GP: general practitioner; NDIS: national disability insurance scheme.
KW - Aboriginal and Torres Strait Islander
KW - childhood
KW - cross-sector collaboration
KW - disability
KW - interprofessionality
KW - service access
UR - http://www.scopus.com/inward/record.url?scp=85076520051&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076520051&partnerID=8YFLogxK
U2 - 10.1080/13561820.2019.1692798
DO - 10.1080/13561820.2019.1692798
M3 - Article
C2 - 31821054
AN - SCOPUS:85076520051
SN - 1356-1820
VL - 34
SP - 388
EP - 399
JO - Journal of Interprofessional Care
JF - Journal of Interprofessional Care
IS - 3
ER -