Effective collaboration between physicians, the MSA and local health authority leaders is a key ingredient for achieving results in projects. Sites can support this by:

• Building a good working relationship with the local site director and engaging operations from the get-go.
   
• Connecting the right people together early in a project to help to avoid duplication of work.
   
• Clarifying health authority leadership roles and responsibilities to support more effective navigation of structures and decisions.
   
• Ensuring the health authority is involved in input and updates for proposals and projects that involve their operations, and/or staff.
   
• Having local department heads / representatives on the engagement working group join relevant priority project teams.
   
• Arranging for support from the health authority to manage and follow up aspects of projects –such as from administrative, strategic or project management staff.

For regional-level projects, both local site and regional health authority administrators should be involved from the beginning to ensure that processes and decisions can be directed and actioned appropriately.
 

Representation and participation from MSA executive members should be considered for appropriate local, regional and provincial committees and working groups.   
 

Planning between the MSA and health authority to develop and align both the health authority and MSA strategic plan and goals is likely for lead to better results. It also creates opportunities for physicians to develop ideas and strategies that can be realistically actioned to accomplish goals.

Having health authority leaders such as local site directors, administrators and/or Medical Directors  participate in Engagement Working Group meetings is effective to build and provide supportive relationships.

Along with goal-setting and solutions, it is helpful to establish values and principles for all partners at MSA Working Group and project meetings – to act with humility, transparency, collaboration, effective and respectful communication.

Regular communication and feedback is crucial to close the loop with members and participants during and after engagement.

Health authorities can support communication and trust-building by keeping medical staff regularly updated on site information, new initiatives and team building by sharing information through an MSA website or newsletter.

With priorities, workload and fatigue related to COVID-19, engagement momentum and awareness, activities, relationship-building has slowed.

Both the MSA and health authority can benefit from having meaningful post-COVID-discussions to harness what was learned, advance fresh ideas and quality improvement, and to rebuild momentum, resilience and partnerships.

Many sites are working on succession planning and activities, and improved onboarding. Efforts are more efficient and more likely to achieve desired results if done in collaboration at all levels: locally, regionally and provincially with the MSA, Division and health authority, instead of as one-off efforts. 

MSAs, health authorities should work with partners (e.g. Specialist Services Committee) and consider how to advance successful projects and changes to different levels.  Planning is underway for spread projects.