NURS 236A
Phyllis M. Connolly
PhD, APRN, BC, CS
Collaboration
Collaboration
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What is it?
How does it fit with the societal needs?
How does society benefit?
What is the relationship to health care?
What does it take?
How does the nurse administrator facilitate
collaboration?
 What are the outcomes?
Definition
 A dynamic transforming process of
creating a power sharing partnership for
pervasive application in health care
practice, education, research, &
organizational settings for the purposeful
attention to needs and problems in order to
achieve likely successful outcomes
(Sullivan, 1998, p. 6)
Collaboration
 “One of many concepts whose greater
currency seems to reflect a larger societal
search for meaning beyond individual
achievement and technical efficiency”
(Hobbs, 1998, p. 593).
Moving out of Communities
 20th C moved from an agrarian society
confined to communities--sustained a sense
of community
– sense of self worth not separated from one’s
work
– communities were holistic and cooperative
Societal Changes
 Industrial era, mass production
– work separated from community and household
 “We have put our own good , as individuals as
groups, as a nation ahead of the common good”
(Bellah et al., 1985, p. 285)
 Services stage
 Information Age—speed
– High Tech High Touch
Societal Shifts
 Nationalism replaced
with global economy
 Social ecology--needs
for integration &
connections
 Social capital-networks, norms,
trust, coordination &
cooperation
Social Capital
 features of social organization such as
networks, norms and trust, that facilitate
coordination and cooperation for mutual
benefit (Putnam1993, p.4)
 enhances the benefits of investment in
physical and human capital
 quality of the interpersonal relationships &
networks among organizations is a
resource that has a positive effect on a
wide range of outcomes (Hobbs, 1998, p.
616)
TRENDS
 High-value
organizations depend
on and expect workers
at all levels to be
capable of making
decisions
 Health care being
driven by changes in
industry
 New organizations
 New forms of
delivery systems-managed care
 New ways of relating
to each other
 Smaller companies
 Outsourcing
 Disease management
Telecommunications
– Greater use will increase
collaboration among health
care professionals in
physically separated
locations
– Over 50% of US
workforce employed in
information related jobs
Changing Work Environment
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Technology
Demographics
Managed Care
Purchaser’s Influence
Health Insurance
Industry
 Changing Health
Systems
 Telemedicine
Prosumer Ethic
 Consumer
collaboration needed
for health care reform
 Merging of consumer
and producer sharing
data and knowledge
 Participation in
planning care most
significant effect on
patient satisfaction
(Chang, 1984)
 Professional shifts
from impersonal
expert to listener,
teacher, and guide
(Toffler, 1980)
“It is only through the joint efforts of the
professional and the consumer, united for
the purpose of bringing about reform, that
reform will actually take place”
(Fairweather, 1980, p. 96).
Relationship to Health
 Concern not only with costs & benefits
but with social, emotional, & physical
health
 Promoting health and providing health
care, no longer the exclusive domain of
any discipline
 Need for interdependence to improve
population health care outcomes
Managed Care Environment
 Focus on outcomes, research based
practice, evidence based practice
 High quality care
 Cost-effective interventions
 Responsible for widespread application
of information technology
Standard VI. Collaboration
 The nurse administrator collaborates with
nursing staff at all levels, interdisciplinary
teams, executive officers, and other stake
holders (ANA, 1995, p. 19).
Conditions
 Supportive environment
 Mutual trust--acquired through
experience among participants
 Disciplinary interests & personal
agendas are secondary
 Process of negotiation
 Team building
 Transformational leadership
 Cannot mandate
Attributes
Cooperation
Assertiveness
Responsibility
Communication
Autonomy
Coordination
United by Trust
Partnership Attributes
 Respecting each other
 Effectively
communicating
 Working together
 Partnership
relationship
 Trusting each other
Shared Elements
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Work
Decision making
Problem-solving
Responsibility
Goal setting
Vision, philosophy,
values, ideas
 Planning
Participation Competence
 Use nondirective & less-analytic processes in
decision making
 Consistently reinforce, using role modeling, the
value & legitimacy of worker involvement
 Identify opportunities for shared decision
making, collaborative projects & relevant
training
 Articulate benefits of high worker involvement &
publication of benefits among all constituencies
(Wilson & Porter-O’Grady, 1999)
 Synergize, value differences (Covey, 1990)
Outcomes
 Increased access
 Improved quality
 Positive client outcomes
 Increased creative solutions
 Improved and increased human
resources
 A more productive community
 Job satisfaction
Collaboration
 Powerful human & social tool-changes people and systems
 Framework for ethical care
 Building healthy communities
– Requires extensive collaboration among
families, institutions, & professionals