132 CHAPTER 5 Table 4. Overview of qualitative findings Dimensions Positive experiences and recent developments Challenges ahead and needs for improvement Normative integration • Increased sense of urgency of importance first thousand days • Increased mutual acquaintanceship (knowing each other) • Visionary leaders facilitated Solid Start (e.g. national advocates and local ‘coalition of the willing’) • Further transcending domain perceptions and overcoming cultural differences and fragmented structures Professional integration • Agreements on interdisciplinary collaboration have increased • Multidisciplinary guidelines, protocols, interventions and policies for Solid Start have increased • Shared goal to provide every child a solid start stimulated collaboration • Experiencing value creation (‘what’s in it for me as a professional’) stimulated collaboration • Successful implementation of agreements, guidelines, protocols, interventions and policies in practice • Integration of Solid Start into all professionals’ daily practice Organizational integration • Centering the needs of the target population as binding agent stimulated collaboration • Dedicated initiators or project leaders were a driving force • Increased learning and knowledge sharing • Increased monitoring and evaluation • Learning community to support the setup of local monitoring • Experiencing value creation (‘what’s in it for the organization’) stimulated collaboration • Support from (executive) board members and aldermen • Continuation of driving forces at institutional level • Challenges related to organizational features • Complexity in one sector hinders crosssector collaboration • Challenges in monitoring like data-availability, selecting relevant indicators, correct interpretation • Continuing learning between and within Solid Start coalitions • Learning from sectors other than Solid Start (e.g. elderly care) and disseminating knowledge based on Solid Start experiences to other sectors Clinical integration • Increased attention for continuity of care, case management and clientcentered care • Improved interpersonal interaction between clients and professionals • Increased client involvement in the organization of care • Increased client involvement in daily practice (shared decision-making) • Learning programs to support client involvement • Further shifting from supply-oriented care and support to prioritizing clients’ needs • Improving interpersonal interaction • Standardizing client involvement • More involvement of partner/spouse and wider informal network • Better focus to clients’ experiences and satisfaction for improvements • Improving the completeness, diversity and communication of clientinformation to enhance alignment and identification. Functional integration • Support for coalition building and implementation of Solid Start activities at local level • Integrated information system to share information between professionals
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