How Do Area Agencies on Aging Build Partnerships With Health Care Organizations?

Abstract

Background and Objectives Partnerships between health care and social service organizations may contribute to lower health care use and spending. Such partnerships are increasing, including Area Agencies on Aging (AAAs) working and contracting with health care organizations. Nevertheless, knowledge about how AAAs establish and manage successful collaborations is limited. We sought to understand how AAAs establish and manage partnerships with health care organizations. Research Design and Methods We conducted an explanatory sequential mixed-methods study using a positive deviance approach. We used national-level data to identify AAAs with multiple health care partners serving areas with low utilization of nursing homes by residents with low-care needs (n=9), and AAAs with few health care partners and high utilization for comparison (n=3). We conducted in-depth interviews with key informants from these 12 AAAs and their partner organizations (total n=130). A 5-person multidisciplinary team used the constant comparative method of analysis, supported by Atlas.ti software. Results Highly-partnered AAAs were characterized by 3 distinctive features of organizational culture: 1) attention to external environments, 2) openness to innovation and change, and 3) risk taking to learn, improve and grow. AAAs and partners describe a broad set of organizational strategies and partnership development tactics, depending on their local contexts. These features were underdeveloped in AAAs with few health care partnerships. Discussion and Implications While federal and state policies can create more favorable environments for AAA-health care partnerships, AAAs can also work internally to foster an organizational culture that allows them to thrive in dynamic and challenging environments.

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

“…In six articles, the criteria for the selection of PDs were unclear or unspecified [ 39 , 47 , 50 , 76 , 143 , 145 ] and in the remaining papers, the selection of PDs does not apply as they are systematic reviews [ 20 , 57 , 59 , 63 ] and adoption program papers that are implemented based on best practices identified from other positive deviant practices [ 28 , 51 , 54 , 67 , 92 , 119 ]. However, performance-based criteria have been used to identify PDs at individual, health facility or health system levels in majority of the articles [ 11 , 23 , 24 , 26 , 27 , 30 , 32 , 33 , 35 – 38 , 40 – 46 , 48 , 53 , 55 , 56 , 60 – 62 , 65 , 66 , 68 – 75 , 77 , 78 , 80 – 88 , 90 , 93 , 95 – 97 , 99 – 105 , 107 – 118 , 121 , 122 , 124 – 142 , 144 ].…”

Primary care physicians' perspectives and challenges on managing multimorbidity for patients with dementia: a Japan–Michigan qualitative comparative study

“…There were systems or organizations in Japan and Michigan that have been established to serve this purpose, such as Japan’s community-based integrated care system [ 40 ] or Area Agency on Aging in Michigan [ 55 ]. However, the cooperation with those organizations and medical institutions are still in the developmental stages [ 56 , 57 ]. For caring community dwelling older adults with multimorbidity including dementia, the collaboration needs to be promoted with more access to relevant information.…”

Perspectives on National Institutes of Health Funding Requirements for Racial and Ethnic Diversity Among Medical Scientist Training Program Leadership

“…We enrolled programs until theoretical saturation was achieved (no new concepts emerged with successive interviews). 14 As is common in positive deviance studies, 15 , 16 , 17 , 18 , 19 saturation required more interviews with participants from high-performing programs than low-performing programs because participants from high-performing programs had deeper experience with the phenomenon of interest. Participants provided verbal informed consent to participate, and the study was approved by an institutional review board at Yale University.…”