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Co-Creating Healthy, Innovative and Humane Organizations, Networks and Eco Systems: A Global Discovery Roundtable
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Anthony Suchman, MD, MA
Co-Creating Healthy, Innovative and Humane Organizations, Networks and Eco Systems: A Global Discovery Roundtable
October 3, 2013
Relational Coordination in Healthcare
McArdle Ramerman Center
Operations Agents
Pilots
CabinCleaners
Caterers
BaggageAgents
GateAgents
RampAgents
TicketAgents
FreightAgents
Mechanics
Fuelers
FlightAttendants
Passengers
Flight departure process: A coordination challenge
© 2012 Relational Coordination Research Collaborative and McArdle Ramerman Center2
c 2012 Jody Hoffer Gittell
Shared goals
Shared knowledge
Mutual respect
Frequent communication
Timely communication
Accurate communication
Problem-solving communication
Relational Coordination
c 2012 Jody Hoffer Gittell
Relational coordination and flight departure performance
Efficiency Quality
Gate time/ flight
Staff time/ passenger
Customer complaints
Lost bags
Late arrivals
Relational coordination -.21*** -.42*** -.64*** -.31* -.50**
Flights/day -.19**** -.37*** -.30*** .13 -.22+
Flight length, passengers, cargo
.79*** .45*** .13 .12 -.54**
Passenger connections .12** .19** .09 .13 .00
R squared .94 .81 .69 .19 .20
c 2012 Jody Hoffer Gittell
Relational coordination and flight departure performanceQ
uality
/effi
cie
ncy p
erf
orm
an
ce
ind
ex
AMR2
AMR1
UNI2
UNI1
CON1 UNI3
CON2
SWA2
SWA1
Relational coordination
CaseManagers
Physical Therapists
NursesAttendingPhysicians
NursingAssistants
SocialWorkers Technicians
ReferringPhysicians
Administrators
Patients
Patient care:A coordination challenge
© 2012 Relational Coordination Research Collaborative and McArdle Ramerman Center6
c 2012 Jody Hoffer Gittell
Relational coordination and surgical performance
Length of stay
Patient satisfactio
n
Freedom from pain Mobility
Relational coordination -.33*** .26*** .08* .06+
Patient age .02 .00 .01 .04
Comorbidities .09* .07 .01 .04
Pre-op status .03 .01 .20*** .28***
Surgical volume .11** .10* .06+ .03
R Squared .82 .63 .50 .22Observations are patients (n=878) in hospitals (n=9). Model also included gender, marital status, psychological well-being and race. Standardized coefficients are shown.
c 2012 Jody Hoffer Gittell
Qu
ality
/effi
cie
ncy p
erf
orm
an
ce
ind
ex
Hosp2
Hosp1
Hosp7
Hosp3Hosp9
Hosp5
Hosp6
Hosp8
Hosp4
Relational coordination
Relational coordination and surgical performance
c 2012 Jody Hoffer Gittell
Relational coordination also improves worker outcomes
Reduces emotional exhaustion and burnout
Increases professional efficacy
Increases job satisfaction
Increases career satisfaction
Increases capacity to learn from failure
c 2012 Jody Hoffer Gittell
Applications of Relational Coordination
Fostering group reflection to improve organizational, workgroup and individual performance
Proactive team-building
c 2012 Jody Hoffer Gittell and Anthony Suchman
Dimension of Relational Coordination
Average for All Work Groups
Average for Physicians
Individual Low Score
Individual High Score
Frequent Communication
4.47
4.31 3.74 4.72
Timely Communication
3.81
3.72 3.22 4.00
Accurate Communication
3.97
3.94 3.69 4.14
Problem-Solving Communication 3.63
3.40 2.76 3.89
Shared Goals
3.85
3.62 3.36 3.77
Shared Knowledge
3.53
3.52 3.31 3.62
Mutual Respect
3.60
3.32 2.97 3.65
Overall Relational Coordination
3.88
3.74 3.44
3.98
Results of First Relational Coordination Survey
c 2012 Jody Hoffer Gittell and Anthony Suchman
Avg for all
groups
Physavg
Phys 1 Phys 2 Phys 3 Phys 4 Phys 5
T1
T2
3.88
4.08
3.73
4.10
3.58
4.19*
3.98
4.23
3.84
4.02
3.44
3.84
3.87
4.07
Pre- and post-intervention survey scores
c 2012 Relational Coordination Research Collaborative and McArdle Ramerman Center
Improving relational coordination
Mutual respect Communication skills Team-building Relational meeting practices Process reflection Leadership development
Shared goals Assessing convergence Collaborative planning Dialog
Shared knowledge “Conversations of interdependence”
Bibliography
Gittell JH. High Performance Healthcare. New York: McGraw Hill; 2009
Relational Coordination Research Collaborative http://rcrc.brandeis.edu
Summary of research on the association of RC with various dimensions of organizational performance available at:http://MakeWorkingBetter.com/RC
Suchman A, Sluyter D, Williamson P. Leading Change in Healthcare. London: Radcliffe, 2011
