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A model and typology of collaboration between professionals in healthcare organizations.

D'Amour D, Goulet L, Labadie JF, Martín-Rodriguez LS, Pineault R - BMC Health Serv Res (2008)

Bottom Line: The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes.Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. danielle.damour@umontreal.ca

ABSTRACT

Background: The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec. The objectives are to: 1) validate the indicators of the structuration model of collaboration; 2) evaluate interprofessional and interorganizational collaboration in four health regions; and 3) propose a typology of collaboration

Methods: A multiple-case research strategy was used. The cases were the healthcare facilities that offer perinatal services in four health regions in the province of Quebec (Canada). The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions. Written material was also analyzed. The data were subjected to a "mixed" inductive-deductive analysis conducted in two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases.

Results: The collaboration indicators were shown to be valid, although some changes were made to three of them. Analysis of the data showed great variation in the level of collaboration between the cases and on each dimension. The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.

Conclusion: The model and the typology make it possible to analyze collaboration and identify areas for improvement. Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes. Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.

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The Four-Dimensional Model of Collaboration. This figure shows the four dimensions of the model of collaboration and the ten indicators associated with these dimensions. The arrows indicate the interrelationships between the four dimensions and how they influence each other.
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Figure 1: The Four-Dimensional Model of Collaboration. This figure shows the four dimensions of the model of collaboration and the ten indicators associated with these dimensions. The arrows indicate the interrelationships between the four dimensions and how they influence each other.

Mentions: The model suggests that collective action can be analyzed in terms of four dimensions operationalized by 10 indicators (Figure 1). Two of the dimensions involve relationships between individuals and two involve the organizational setting (which influences collective action). As Figure 1 shows, the four dimensions are interrelated and influence each other. The relational dimensions are: 1) Shared Goals and Vision, which refers to the existence of common goals and their appropriation by the team, the recognition of divergent motives and multiple allegiances, and the diversity of definitions and expectations regarding collaboration; and 2) Internalization, which refers to an awareness by professionals of their interdependencies and of the importance of managing them, and which translates into a sense of belonging, knowledge of each other's values and discipline and mutual trust. One of the organizational dimensions is 3) Formalization (structuring clinical care), defined by Bodewes [20] as "the extent to which documented procedures that communicate desired outputs and behaviours exist and are being used" (p. 219). Formalization clarifies expectations and responsibilities. The other organizational dimension is 4) Governance, that is, the leadership functions that support collaboration. Governance gives direction to and supports professionals as they implement innovations related to interprofessional and interorganizational collaborative practices. Together, these four dimensions and the interaction between them capture the processes inherent in collaboration. They are subject to the influence of external and structural factors such as resources, financial constraints and policies. Though these factors are beyond the scope of this article, they must be taken into account as determinants of collaborative processes.


A model and typology of collaboration between professionals in healthcare organizations.

D'Amour D, Goulet L, Labadie JF, Martín-Rodriguez LS, Pineault R - BMC Health Serv Res (2008)

The Four-Dimensional Model of Collaboration. This figure shows the four dimensions of the model of collaboration and the ten indicators associated with these dimensions. The arrows indicate the interrelationships between the four dimensions and how they influence each other.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2563002&req=5

Figure 1: The Four-Dimensional Model of Collaboration. This figure shows the four dimensions of the model of collaboration and the ten indicators associated with these dimensions. The arrows indicate the interrelationships between the four dimensions and how they influence each other.
Mentions: The model suggests that collective action can be analyzed in terms of four dimensions operationalized by 10 indicators (Figure 1). Two of the dimensions involve relationships between individuals and two involve the organizational setting (which influences collective action). As Figure 1 shows, the four dimensions are interrelated and influence each other. The relational dimensions are: 1) Shared Goals and Vision, which refers to the existence of common goals and their appropriation by the team, the recognition of divergent motives and multiple allegiances, and the diversity of definitions and expectations regarding collaboration; and 2) Internalization, which refers to an awareness by professionals of their interdependencies and of the importance of managing them, and which translates into a sense of belonging, knowledge of each other's values and discipline and mutual trust. One of the organizational dimensions is 3) Formalization (structuring clinical care), defined by Bodewes [20] as "the extent to which documented procedures that communicate desired outputs and behaviours exist and are being used" (p. 219). Formalization clarifies expectations and responsibilities. The other organizational dimension is 4) Governance, that is, the leadership functions that support collaboration. Governance gives direction to and supports professionals as they implement innovations related to interprofessional and interorganizational collaborative practices. Together, these four dimensions and the interaction between them capture the processes inherent in collaboration. They are subject to the influence of external and structural factors such as resources, financial constraints and policies. Though these factors are beyond the scope of this article, they must be taken into account as determinants of collaborative processes.

Bottom Line: The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes.Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. danielle.damour@umontreal.ca

ABSTRACT

Background: The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec. The objectives are to: 1) validate the indicators of the structuration model of collaboration; 2) evaluate interprofessional and interorganizational collaboration in four health regions; and 3) propose a typology of collaboration

Methods: A multiple-case research strategy was used. The cases were the healthcare facilities that offer perinatal services in four health regions in the province of Quebec (Canada). The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions. Written material was also analyzed. The data were subjected to a "mixed" inductive-deductive analysis conducted in two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases.

Results: The collaboration indicators were shown to be valid, although some changes were made to three of them. Analysis of the data showed great variation in the level of collaboration between the cases and on each dimension. The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.

Conclusion: The model and the typology make it possible to analyze collaboration and identify areas for improvement. Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes. Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.

Show MeSH