LESSON LEARNED

The Power of Partnerships

Strengthening co-creation processes and partnerships to support outcomes for Children with Complex Needs

Co-creation refers to involving those affected by services, programs, policies, or practices in their design and delivery. It requires proactive and intentional relationship building with key partners collaboratively working together to improve outcomes. Partners offer input into an intervention or practice expected to benefit those affected – and in the behavioral health environment, especially children, families, and communities. Co-creation partners may include executive leaders, service delivery staff, local/state government and regulatory bodies, community organizations, policymakers, educational/academic representatives, purveyors, and community members (families, youth, those with lived experience) – anyone who is involved or impacted by a change effort (program, policy, practice, or innovation being implemented).

What this can look like in practice

Local management entities/managed care organizations (LME/MCOs) work in partnership with North Carolina’s Department of Health and Human Services (DHHS) to serve children with complex needs and ensure that youth and their families have access to and receive appropriate care. Within each of the four LME/MCOs across our state, a designated Point of Contact staff member works to oversee the service delivery for children with complex needs. This person connects staff and providers with network- enhanced supports such as high-quality training, coaching, problem-solving, and navigating the managed care administrative system. As Points of Contact support effective programmatic functions, they seek to apply implementation science best practices, building local capacity to do this work well and achieve
effective results.

To realize desired outcomes, Points of Contact attend to building and sustaining co-creation capacities for those caring for children with complex needs. Points of Contact recognize that it takes many cross-system and within-system coordinated efforts best accomplished through effective partnerships. Practically speaking, this approach includes cross-department teams and team structures, and intra-agency collaborations that build professional relationships among community providers and system partners. The “who” is a critical team or group to clearly identify and work together to carry out the “what”, referring to the identified practices, programs, and policies designed to meet the needs of children and families. The “what” also includes attending to the support system for what is being implemented. Co-creation partners help envision an optimal system where things go well, and work with partners to break down implementation barriers along the way.

One strategy that Points of Contact used to develop capacity to partner and team together was to collaboratively develop a shared document outlining key internal activities needed to effectively serve children with complex needs. Collectively during their monthly planning calls throughout the 2021-2022 fiscal year, the group brainstormed essential LME/MCO functions and structures required to carry out the
work and who needs to be involved, spanning leadership, care management, data/quality management, finance, utilization management, provider network, and IT support. This activity guided thoughtful discussions around what effective teaming can look like to support success, address barriers and challenges. The discussions helped Points of Contact converge on how effective work could be done by paying stronger attention to co-creation within their agencies. Concepts such as teaming, building effective communication protocols and practices, feedback and feed-forward loops, improving the use of data and collaborative reporting activities, coaching, etc. emerged through their explorations.

Individual Points of Contact staff members also shared how cultivating partnerships with external service providers in the community paves the way for better meeting the needs of their most complex cases and fostering improved outcomes when seeking to implement a specific program, strategy, or initiative. Taking the time to build trust, define what success looks like, and have a clear understanding of roles and responsibilities to achieve mutually beneficial outcomes contribute to well-functioning support systems better positioned to adequately address the needs of the children, families, and communities being served.

At-A-Glance Best practices for authentic co-creation

  1. Determine how you will ensure inclusivity of all co-creation partners (anyone who is involved or impacted by a change)
  2. Change moves at the speed of trust! Take time to build trust and relationships among partners; tend to power differentials
  3. Create bi-directional communication pathways for feedback and feedforward loops
  4. Build a shared vision for success through clearly defined roles, responsibilities, and mutual goal setting

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