Quantifying relational change in community organisations participating in a Veteran suicide prevention learning collaborative: a social network analysis.

BACKGROUND: Veteran suicide remains a significant issue, as 17.5 Veterans die by suicide each day. The US Department of Veteran Affairs (VA) has implemented a robust suicide prevention program within its integrated behavioural health system. Further, the VA has increasingly contributed to suicide prevention in community settings, where a large proportion of Veterans receive health care and social services. One component integral to preventing suicide among Veterans receiving community services is ensuring that organisations are equipped with the latest evidence-based Veteran-specific suicide prevention strategies. METHODS: The Patient Safety Center of Inquiry-Suicide Prevention Collaborative piloted a Veteran suicide prevention learning collaborative in the Denver/Colorado Springs, CO region, spanning 16 months as a multimodal initiative to integrate community organisations and assist them in implementing Veteran suicide prevention strategies used within VA. Agencies completed social network analysis surveys at baseline (T1), year 1 (T2) and 16 months (T3) to examine social networks, partnerships and collaborations among community organisations and the VA over time. RESULTS: The quantity of learning collaborative relationships increased from 30 at T1 to 41 at T3 while the quality of relationships deepened over time from awareness and cooperative to more coordinated and integrated. CONCLUSION: Improvement in relationship quantity and quality facilitates community organisation engagement in collaborating to strengthen their Veteran suicide prevention programming. Learning collaboratives work with the individual organisation for intraorganisational facilitation of implementing suicide prevention strategies and engage and enhance interorganisational partnerships. This multimodal intervention can engage community organisations and provide a stronger safety net for Veterans at risk for suicide.

Contributions of Health Care Coalitions to Preparedness and Resilience: Perspectives From Hospital Preparedness Program and Health Care Preparedness Coalitions.

OBJECTIVE: The purpose of this article was to describe how the Hospital Preparedness Program (HPP) and other health care coalitions conceptualize and measure progress or success and to identify strategies to improve coalition success and address known barriers to success. METHODS: We conducted a structured literature review and interviews with key leaders from 22 HPPs and other coalitions. Interview transcripts were analyzed by using constant comparative analysis. RESULTS: Five dimensions of coalition success were identified: strong member participation, diversity of members, positive changes in members' capacity to respond to or recover from disaster, sharing of resources among members, and being perceived as a trendsetter. Common barriers to success were also identified (eg, a lack of funding and staff). To address these barriers, coalitions suggested a range of mitigation strategies (eg, establishing formal memoranda of agreement). Both dimensions of and barriers to coalition success varied by coalition type. CONCLUSIONS: Currently, the term health care coalition is a one-size-fits-all term. In reality, this umbrella term describes a variety of different configurations, member bodies, and capabilities. The analysis offered a typology to categorize health care coalitions by primary function during a disaster response. Developing a common typology that could be used to specify capabilities or functions of coalitions may be helpful to advancing their development.