title: Cross-ministerial collaboration related to paediatric rehabilitation for children with disabilities and their families in one Canadian province.
abstract: The delivery of paediatric rehabilitation services is complex due to the involvement of different service sectors and diverse models of care. Parents of children with disabilities find it challenging to navigate successfully through complicated service delivery systems. Cross-sectoral collaboration to improve continuity of care for children with disabilities and their families is viewed as ideal in public policies. The purpose of this research was to explore how ministerial cultures, processes and structures influence inter-ministerial collaboration for the purpose of enhancing continuity of care for children with disabilities and their families in a Western Canadian province. Six key informants from three government Ministries that funded paediatric rehabilitation services participated in individual, semi-structured interviews between January and May of 2007. Nineteen provincial public policy documents were reviewed. Hall's framework guided the analysis of the key informant interviews and policy documents. Influences of organisational culture, processes and structures on cross-ministerial collaboration were classified into the categories of ideas-values and beliefs that underlie policy development, interests-influence of various policy actors and institutions-structures and processes used to deliver public policy. Fundamental ideological and structural differences were apparent across the three ministries that affected the ease of inter-ministerial collaboration towards ensuring continuity of care for children with disabilities. Variations in ideas (philosophy and values) and institutions (geography and service delivery structure, relationships with regional governance, mission and function, choice of policy instruments and financial processes) are presented and implications for service delivery are explored.
authors.affiliation: Faculty of Nursing, University of Alberta and Alberta Centre for Child, Family and Community Research, 9925-109 Street, Edmonton, AB, Canada. lesley.wiart@ualberta.ca
authors.forename: Lesley
authors.initials: L
authors.lastname: Wiart
authors.forename: John
authors.initials: J
authors.lastname: Church
authors.forename: Johanna
authors.initials: J
authors.lastname: Darrah
authors.forename: Lynne
authors.initials: L
authors.lastname: Ray
authors.forename: Joyce
authors.initials: J
authors.lastname: Magill-Evans
authors.forename: John
authors.initials: J
authors.lastname: Andersen
mesh_terms: D000416:Alberta; D002648:Child; D002669:Child Welfare; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005843:Geography; D006801:Humans; D010287:Parent-Child Relations; D010372:Pediatrics; D011640:Public Policy; D036301:Qualitative Research; D016896:Treatment Outcome