Forming a successful public health collaborative: A qualitative study.

BACKGROUND:Coordinated approaches are needed to optimally control the spread of resistant organisms across facilities that share patients. Our goal was to understand social tensions that may inhibit public health-led community partnerships and to identify factors for success. METHODS:A collaborative to control transmission of multidrug-resistant organisms (MDROs) was formed in Utah following a regional outbreak, with members from public health, hospitals, laboratories, and transport services. We conducted and qualitatively analyzed 3 focus groups among collaborative stakeholders to discuss their experiences. RESULTS:Via 3 focus groups and additional interviews, we found the collaborative made institutional tensions between stakeholders explicit. We identified 4 factors that facilitated the ability to overcome institutional tensions: public health leadership to establish a safe space, creation of cross-institutional group identity with mutual respect and support, standardized communication, and group cohesiveness through shared mental models of interdependencies. DISCUSSION:Stakeholders' concerns regarding being blamed for MDRO transmission versus contributing to shared health care community MDRO control efforts resembled a "prisoner's dilemma." Four social components mitigated tensions and facilitated cooperation in this public health-led collaborative. CONCLUSIONS:This study identified strategies that public health-led coordinated approaches can use to facilitate cooperation.