Nowadays, many healthcare and social care organizations are discovering that it is difficult to build robust referral networks. Despite indicating a need for an infrastructure to facilitate cross-sector referrals and service coordination, research suggests that local providers did not achieve higher efficiency from implementing this type of software. This is because they are relying primarily on the technology’s adoption, not what we know about effective multi-sector network design.
Our blog series about the Sustained Collaboration Report has detailed how non-profit leaders can work together to maximize social impact. Now, let’s delve into the broader landscape of multi-sector collaboration and explore the critical factors needed to ensure its success.
What is Multi-sector Collaboration?
Multi-sector collaboration is the partnership between organizations in different domain areas (e.g., health, human services, arts) or business models (e.g., for-profit, government nonprofit) to achieve a common goal. This type of cooperation is often required to tackle systemic or widespread issues because it can bring together diverse expertise, resources, and perspectives, resulting in more comprehensive and effective solutions. These “wicked problems” cannot be addressed by a single organization or a group of similar organizations, as they often involve complex challenges spanning various realms.
In healthcare, entities such as insurance companies, medical providers, and social service agencies may engage in multi-sector collaboration to tackle health-related social needs (HRSNs) more effectively. Technologies like inter-agency referral management systems are crucial in supporting this partnership. After conducting HRSN screening, insurance and healthcare providers can seamlessly refer patients to social service organizations for assistance with housing, nutrition, transportation, and other needs.
Considerations Regarding Multi-sector Network Design
Since a multi-sector network requires more coordination than traditional partnerships, all entities who wish to participate in this type of collaboration should take essential considerations. First and foremost, they must create a compelling vision for why the network is required to solve a particular societal problem. Next, leaders must also make critical choices regarding the network’s focus (defining the specific social issues to be addressed), type (determining the desired scope and scale of impact), innovation (identifying suitable technologies that can be applied), and approach (establishing the overall methodology for collaboration).
Moreover, the multi-sector network must be co-designed by those who will use it, not just one institution. Co-design ensures the collaboration initiative is tailored to all stakeholders’ specific needs, priorities, and perspectives, fostering greater ownership and efficacy. Key network design questions include:
- Who will convene and manage the network?
- Who should participate? What are the conditions for participation?
- How will different types of decisions be made?
- What are our goals? How will we measure progress on those goals?
- How will we communicate about the network and its successes/failures?
- What funding mechanisms will the network use?
- What are the roles and relationships among the organizations in the network?
The network can ensure clarity, transparency, and alignment among participating agencies by answering these questions before embarking on a multi-sector collaboration.
Ensuring Effective Operations of Multi-Sector Networks
1. Fund Mobilization
Networks are not free; there are costs associated with coordination, technical expertise, and data systems, among other things. In a multi-sector collaboration, these costs can be magnified due to the diverse nature of the involved entities. Therefore, the network must secure sufficient funding to support its goals. The health system can’t be the only institution getting paid for their work. Research shows that many community-based organizations are not paid based on the number of clients they serve. As such, referrals do not equate to more financial resources, and in many cases, increased referrals strain the system’s capacity significantly.
There are several ways that funds can be mobilized to support health and human service networks. Member organizations may self-fund the network by contributing on a sliding scale based on revenues or donating equal amounts to a shared endowment fund. Other frequently used funding sources are external grants from government agencies, private foundations, and international organizations. This method is more sustainable than self-funding, as it relies on something other than the financial status of network members. In addition, community-based organizations may be incentivized by some states to participate in the network or can receive Medicaid payments for services (e.g., North Carolina Healthy Opportunities Pilot).
If the multi-sector partnership needs more funding, it may need to adjust operational processes accordingly, for example, scaling down the scope of projects to match available resources. Alternatively, an asset-based approach can be adopted to set achievable goals for the network. An asset-based approach involves identifying and leveraging the strengths and capabilities of member organizations to accomplish objectives within existing financial constraints.
2. Conflict resolution
Conflict is unavoidable in multi-sector collaboration and can occur at one of three interfaces. First, individual-organization dilemmas often arise because the representatives of member organizations are not fully committed to the collaborative efforts. Meanwhile, conflict stems from differences in individual organizations’ expectations or approaches to network activity at the organization-network interface. Finally, network-community conflicts might result from systemic barriers in the local community or the network’s lack of impact.
Implementing conflict resolution mechanisms like the VOICE heuristic is crucial in facing these challenges. This method aims to reframe network participant thinking and bridge the gap between contrasting perspectives. Each letter of the acronym represents a sub-basis for questions that should be addressed by parties in conflict, providing a healthy atmosphere for debate and discussion. In a multi-sector collaboration, the VOICE heuristic will be especially useful in fostering mutual understanding because it ensures that decisions are made considering each stakeholder’s values, concerns, and interests.
3. Data Integration
Data systems allow networks to determine community needs, benchmark member organizations’ performance, and assess the outcome of activities. As a result, data should be used to support the network’s theory of change, not just as an incentive for participation or an evaluation tool.
At NNSI, we recommend that multi-sector partnerships adhere to three principles when working with data. First, any data collection systems created should be easy to use and compatible with member organizations’ existing methods. Second, financial rewards should be provided to entities that meet specific criteria to incentivize data entry and goal setting. Third, appropriate statistics should be used to evaluate whether agencies from different sectors are working well together to achieve common goals.
However, network instigators should hold two truths about data in tension: you cannot manage what you cannot measure, and everything does not boil down to numbers. By understanding the limits of data and learning to adapt it to their theory of change, multi-sector partnerships can make more informed decisions.
For more helpful insights into operating successful multi-sector collaborations, please check out the Tips and Tools for Network Instigators blog series on our website.