Hoffer Gittell, J - Relational Coordination for Compassion and Business Conference

7/30/2019 Hoffer Gittell, J - Relational Coordination for Compassion and Business Conference

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Relational Coordination for

High Performance:Embedding Reciprocal Relationships into Roles

Jody Hoffer GittellProfessor, Heller School, Brandeis University


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Operations

Agents

Pilots

Flight

Attendants

Mechanics

CaterersCabin

Cleaners

Gate

Agents

Ticket

Agents

Ramp

AgentsBaggage

Agents

Fuelers

Freight

Agents

Flight departure process:

A coordination challenge

Passengers


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Case

Managers

Nurses

Attending

Physicians

Physical

TherapistsNursing

Assistants

Social

Workers Technicians

Referring

PhysiciansAdministrators

Patient care:

A coordination challenge

Patient/fami

ly


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Relationships shape the

communication through whichcoordination occurs ...

Findings


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For better...

Relationships

Shared goals

Shared knowledge

Mutual respect

Communication

Frequent

Timely

Accurate

Problem-solving


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Or worse

Relationships

Functional goals

Specialized

knowledge

Lack of respect

Communication

Infrequent

Delayed

Inaccurate

Finger-pointing


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This process is called

Communicating and relating

for the purpose of task integration


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Measuring relational coordination

RC dimensions Survey questions

1. Frequentcommunication

How frequentlydo people in each of these groupscommunicate with you about [focal work process]?

2. Timelycommunication

How timelyis their communication with you about[focal work process]?

3. Accurate

communication

How accurateis their communication with you about

[focal work process]?

4. Problem solvingcommunication

When there is a problem in [focal work process], dopeople in these groups blame others or try to solvethe problem?

5. Shared goals How much do people in these groups share your goalsfor [focal work process]?

6. Sharedknowledge

How much do people in these groups knowabout thework you do with [focal work process]?

7. Mutual respect How much do people in these groups respect the

work you do with [focal work process]?


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Relational coordination and

flight departure performance

Relational coordination

Quality/efficiency

performance

index

AMR2

AMR1

UNI2

UNI1

CON1 UNI3

CON2

SWA2

SWA1


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Relational coordination and

patient care performance

Relational coordination

Quality/efficiency

performance index

Hosp2

Hosp1

Hosp7

Hosp3

Hosp9

Hosp5

Hosp6

Hosp8

Hosp4


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Why and howdoes

relational coordination work?


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Shared goals enable participants to align

their actions with each other

Shared knowledge enables participants to

understand how their tasks fit together

Mutual respectencourages participants tovalue the contributions of others

Together these high quality relationships

support frequent, timely, accurate, problem-solving communication


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Enables participants to connect in a

meaningful way across functional and

organizational boundaries --allowing them to coordinate on the fly


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Enables participants to be more

attentive and responsive to the situation

and to one another

promoting caring and compassion


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RC has been studied in many contexts

Airlines

Software

Banking Pharmaceuticals

Early intervention

Early childhood

education

Surgical care

Acute care

Primary care Chronic care

Long term care


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Improves efficiency performance

Increased employee productivity

Reduced turnaround time

Reduced length of stay Reduced total cost of hospital care

Reduced inpatient hospitalizations

Reduced costs of chronic care

Reduced costs of product development


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Improves quality performance

Increased on-time performance

Reduced customer complaints

Reduced baggage handling errors

Increased patient satisfaction with care

Increased patient psychological well-being Increased patient intent to recommend

Improved post-operative pain/ functioning

Increased quality of life for long-term care residents

Reduced family complaints Reduced medication errors

Reduced hospital acquired infections

Reduced patient fall-related injuries

Increased product development quality


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Improves customer engagement

Increased trust and confidence in the care

provider team

Increased family preparation for caregiving

Increased evaluation, enrollment, retentionof drug exposed infants

Increased self-management support

Increased decision support Increased community linkages


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Improves worker outcomes

Increased job satisfaction Increased career satisfaction

Increased professional efficacy

Reduced burnout/emotional exhaustion

Increased work engagement Increased proactive work behaviors

Increased psychological safety

Increased learning from failures

Increased reciprocal learning

Increased equity of team member contribution

Increased collaborative knowledge creation


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Relational coordination helps organizations toachieve higher quality more efficiently, with greater

customer and worker engagement

Quality

Efficiency

Relational

coordination


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How do organizations support

relational coordination?


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Invest in frontline leadership

Resolve conflicts proactively

Measure team performance

Lead with credibility & caring

Select for teamwork

Make job boundaries flexible

Create boundary spanners

Develop shared protocols

Develop shared info systems

Bridge work/family divide

Relational

Coordination

Relationships

Shared goals

Shared knowledge

Mutual respect

Communication

Frequent

Timely

Accurate

Problem-solving

QualityPerformance

EfficiencyPerformance

Broaden participation in teammeetings

Organizational structures thatsuppor t relational coordination

Worker

Well-Being

CustomerEngagement


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[Our leaders] communicate with customers and

employees on every little issue. Theirphilosophy is to take care of the small problems.

When someone has a problem here, even if it

might seem small, I have to take care of it.

Lead with credibility

and caring


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Youve got to be a nice person to work

hereWe pick it up through theirreferences. The doctors here are also sure

to know someone who knows that

doctor.. . . . Nurses like it here because

physicians respect their input.

Select for teamwork


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We implemented training classes for all

employees that teach employees how to deal with

conflict resolution, including adopting appropriatebehaviors. There is a Pledge to My Peers, which

is a structured format for resolving conflicts in a

peer-to-peer fashion. Aggrieved employees are

encouraged to approach the coworker or

supervisor or whoever and say, I would like to

speak with you regarding the pledge.



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Each person has a specific job, but part of

the job is to help the other person. Thenits easier to work in a more efficient

manner.

Make job boundaries

flexible


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Case managers [here] have to be very very

very good communicators and negotiators

and very assertive but also have a good

sense of timing . Willing to be a patient

advocate but also be able to balance the

financial parameters and think out of the boxand have a system perspective.



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In some cases, its added time for order

entry, but the additional time has been

outweighed by far less aggravation in

trying to locate a record.People

recognize the power of having a system

like provider order entry because you cando incredible medical management just by

providing information at the point of care.

Develop shared

information systems


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We make people take their vacationswe need them to be good members of

their families and communities.

Bridge the work/family

divide


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Invest in frontline leadership


Measure team performance

Lead with credibility & caring

Select for teamwork

Make job boundaries flexible


Develop shared protocols

Develop shared info systems

Bridge work/family divide

Relational

Coordination

Relationships

Shared goals

Shared knowledge

Mutual respect

Communication

Frequent

Timely

Accurate

Problem-solving

QualityPerformance

EfficiencyPerformance

Broaden participation in teammeetings

Organizational structures thatsuppor t relational coordination

Worker

Well-Being

CustomerEngagement


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Organizations can embed reciprocal

relationships of shared goals, shared

knowledge and mutual respect into roles,enhancing

sustainability

scalability

reliability

Bottom line


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Do you know organizations

that do this well?

Documents

Hoffer Gittell, J - Relational Coordination for Compassion and Business Conference