NURS 236A Phyllis M. Connolly PhD, APRN, BC, CS

1. NURS 236APhyllis M. Connolly PhD, APRN, BC, CS Collaboration

2. Collaboration • 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?

3. 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)

4. 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).

5. 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

6. 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

7. Societal Shifts • Nationalism replaced with global economy • Social ecology--needs for integration & connections • Social capital--networks, norms, trust, coordination & cooperation

8. 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)

9. New organizations New forms of delivery systems-- managed care New ways of relating to each other Smaller companies Outsourcing Disease management 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 TRENDS

10. Telecommunications • Greater use will increase collaboration among health care professionals in physically separated locations • Over 50% of US workforce employed in information related jobs

11. Changing Work Environment • Technology • Demographics • Managed Care • Purchaser’s Influence • Health Insurance Industry • Changing Health Systems • Telemedicine

12. Merging of consumer and producer sharing data and knowledge Professional shifts from impersonal expert to listener, teacher, and guide (Toffler, 1980) Consumer collaboration needed for health care reform Participation in planning care most significant effect on patient satisfaction (Chang, 1984) Prosumer Ethic

13. “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).

14. 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

15. 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

16. 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).

17. 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

18. Attributes Cooperation Assertiveness Responsibility Communication Autonomy Coordination United by Trust

19. Partnership Attributes • Respecting each other • Effectively communicating • Working together • Partnership relationship • Trusting each other

20. Shared Elements • Work • Decision making • Problem-solving • Responsibility • Goal setting • Vision, philosophy, values, ideas • Planning

21. 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)

22. Outcomes • Increased access • Improved quality • Positive client outcomes • Increased creative solutions • Improved and increased human resources • A more productive community • Job satisfaction

23. Collaboration • Powerful human & social tool--changes people and systems • Framework for ethical care • Building healthy communities • Requires extensive collaboration among families, institutions, & professionals