Learning to Use Tension to Create Sustainable Partnerships for Responsive Policy and Practice in the Health Sector

IntroductionUniversity and community partnerships combine scientific knowledge often based in academia and community wisdom grounded in community relevance to address practical and long term solutions to broad environmental and health issues. Bringing people together from diverse disciplines requires the development of an effective partnership where partners respect, listen, share expertise, and learn from each other. The key to maintaining a partnership is learning to successfully work through the tensions within the engagement process so that all partners are aware of the broader and sometimes different issues partners are addressing within their respective disciplines. Partners are motivated to gain knowledge about the expertise of partners and are challenged to use a multi-perspective lens when considering issues of common interest.Within the health care sector, there is general acceptance that outcomes for clients improve when stakeholders work in partnership (1). Governments, funding agencies, and professional societies have endorsed initiatives, such as, adopting interprofessional education (2-3), funding multi- partner research (4) and expanding practice teams (5,6).The purpose of this paper is to describe the utility of a partnership model that evolved from a university- community partnership. The development of this model is described elsewhere (7). In this paper, partnership classifications categories are described, health care delivery models are compared, and the importance of naming, expecting, and using tension is discussed, and the environmental context is explored. When using tension, growth and creativity occurs both within the partnership and for each partner. Tension is defined as a strain that generates differences amongst partners; presenting an opportunity for partners to engage in reciprocal learning. When tension is embraced and not perceived negatively as conflict or a barrier to overcome, partners are challenged to think differently and to move toward continued growth and development. Partners are encouraged to venture outside their "comfort zones" to a new space where creative and effective solutions are found. Exemplars that are amalgamated composites of the lived experiences of the authors demonstrate that tension is a positive concept in the engagement process.Partnership classification categoriesThere are many adjectives that describe the attributes or the specific expectations that define a particular partnership. To prevent any language blurring that could potentially create misunderstanding, partnership attributes are classified into categories and exemplars are used to demonstrate the defining elements of each category. When partners from many disciplines collaborate, language clarity sets the stage for mutual understanding.In intradisciplinary - also named unidisciplinary or intraprofessional - members share the same discipline and may have similar values and philosophies even though they may have diverse skills and expertise (8,9). For example, three nurses who work at a Community Health Centre have the common focus of promoting health for all clients who live in a predominately low socioeconomic environment. One nurse may specialize in issues of chronic disease and computer literacy; another may have a specialized interest in diabetes; while another may be involved in school health with a special interest in promoting the health of all children living with chronic illnesses. Even though the common threads of chronic illness and compromised living environments underlie each of their interests, each nurse has a specific skill set and brings a unique perspective to the intradiscipline team goal of addressing the health concerns of community clients. The collaboration between these three nurses is grounded in a primary health care philosophy with a health determinant lens that emphasizes safety and security, and access to accurate and timely health information. …