Abstract Introduction Disasters and public health emergencies can overwhelm healthcare systems, requiring rapid increase in capacity, inter-agency collaboration, and the quick deployment of emergency medical teams. An effective response to these crises requires a structured approach that integrates multiple entities, including healthcare, military, and community organizations. Current frameworks often lack structured methods for optimizing collaboration, which can lead to redundancy and inefficiency. This study aims to address this gap by developing a conceptual framework combining collaboration and integration theories to improve inter-organizational partnerships in emergency management. Methods To develop this framework, a comprehensive literature review was conducted identifying gaps in existing theoretical models of integration and collaboration. We examined integration theory at five distinct levels: structural, functional, normative, interpersonal, and process. Simultaneously, we explored collaboration theory, focusing on socio-cognitive, intersubjectivity, and distributed cognition frameworks. The study then synthesized these theories into a new, combined framework. This framework aligns integration components with key collaborative principles such as shared decision-making, effective communication, and adaptability. To make this framework a practical tool, we incorporated the CSCATTT model (Command and Control, Safety, Communication, Assessment, Triage, Treatment, Transport). This model typically used in collaborative exercises, serves as a practical guide for implementing and evaluating collaboration in real-world scenarios. Results The proposed framework provides a structured approach for responding to disasters and public health emergencies by identifying key points where integration and collaboration can effectively be combined. It demonstrates that integration theory ensures system cohesion and operational efficiency, while collaboration theory fosters adaptability and stakeholder engagement. By aligning these two theories, the framework facilitates more effective multi-agency partnerships. The inclusion of the CSCATTT model enhances structured decision-making, enabling coordinated and efficient action during emergencies. Conclusion By integrating collaboration and integration theories, this study offers a robust model for enhancing partnerships during disasters and public health emergencies. The proposed framework improves resource utilization, inter-agency coordination, cooperation, and overall effectiveness of collaborative responses, all while maintaining system flexibility. Future research should focus on validating this framework through practical applications, such as simulation exercises and real-world deployments.
Zimmerman et al. (Fri,) studied this question.