Partnering is Central to Implementation

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Implementation is an inherently social endeavor. Whether you’re working in research or practice, you have likely formed partnerships. In fact, interpersonal, inter-group, and inter-organizational relationships can make or break implementation success. This is why deeply understanding partnering – that is, how we foster, grow, maintain, and evaluate collective action as part of the implementation process – is incredibly crucial.

People working in systems often have to partner with others as part of the job for different reasons.  This can include securing funding, planning and implementing new programs, launching an evaluation of existing programs, and many more.

However, when we think about what works and doesn’t work in implementation, we usually 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.

all about the loonies

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 understand the “necessary conditions” for scaling up.

Three ways to approach partnering differently.

I have spent a long time understanding relationships between organizations and systems. We have a rich history in the business and social sciences literature – in fact, decades of research – about the nature of inter-organizational relationships. This includes governance structures, overall network structures, and relational processes.

But, in the implementation science literature, these relational factors were largely excluded. While some frameworks 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’m currently developing an evaluation framework that connects partnering processes to implementation goals to fill a gap in the field. Here’s some practical advice that I developed based on this work, and that I often give to others:

1. Find out the contextual and partnership factors.
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 in order to build effective structures (interventions) on top of it.

2. Define 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.

In other words, consider these questions: who is involved in implementation, and how are they are interacting to make implementation happen? Articulating this plan helps to clearly articulate the partnership’s purpose, which further helps develop a shared agenda and common understanding of that agenda. These are key ingredients of an effective partnership.

3. Determine 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 like context or the intervention itself. We should aim to understand the barriers and facilitators to partnering, then select partnering strategies that help to overcome barriers and leverage facilitators.

Researchers are starting to think very deeply about partnering. New papers are being published that highlight the relational components of existing models and frameworks. Those who work with communities are describing their partnership strategies as implementation strategies.

word pairs in a search for “effective partnerships”

It’s exciting that implementation is not being thought of solely as a set of technical tasks, but also as a set of relational processes. This kind of thinking does more than advance the science and practice of implementation – it also has implications for how we consider equity in implementation, and think more broadly about how we implement at a large scale in systems. I am keen on seeing new work that shows partnering as central to implementation, just as it should be.

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