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Collaborating Accross Boundries in Health Care Delivery: What's Old is New

by Diane L. Dixon, EdD

We have been talking about coordinating care and collaborating across boundaries for as long as I have been in health care, more than 25 years.   It is interesting to me with all of the recent debate over the new age of health care reform that we are still talking about collaborating across boundaries as if it is a new initiative.   As so often happens in health care, new names are given for old challenges and invoke a burst of new energy and debate such as what we are experiencing with accountable care organizations (ACOs), for example.  These are groups of providers that come together to provide coordinated care to defined patient populations.  Needless to say, ACOs require collaboration to be effective.

What health care professionals have always known is that to provide person-centered care, you have to work together across multiple boundaries – hospitals, nursing homes, community-based care settings, nurses, physicians, departments, disciplines, etc.   This is not new; we have been talking about it for years.  But somehow when the day-to-day realities emerge, the silos reappear.  One key question for everyone involved with providing person-centered care is: What will it take to minimize the barriers to really collaborate?  What will it take to put egos, competition, blame, and power struggles aside to focus on doing what is right for the person entrusted to care?  What will it take to hold the best interest of the patient, resident or client in the center of all of the variables and professionals that are involved with doing what is best for them?

I have worked with many health care providers over the years and I have not met one yet who did not care about people.  What I continue to learn is that when care delivery is at its best, all who are involved are collaborating well.  There is no doubt that person-centered care is very hard work in today’s complex and demanding environment.   But examples of good collaboration across health care delivery boundaries are all around us.  What can we learn from these positive examples?  What can be done to expand and continuously improve collaboration and, ultimately, person-centered care?  You have the answers.

This is not the time to be sidetracked again by the latest health care debates and politics.  This is not the time to let the swirl of complex issues impacting health care delivery today overwhelm and interfere with what you know in your hearts and minds to be best for people entrusted to you.   This is the time to release old mindsets and conflicts about what did not work in the past and embrace new ways for working together to provide the most effective person-centered care.

Just a few tips to remember when collaborating:

  • Focus on your common purpose
  • Clearly define mutual goals and accountability for outcomes
  • Don’t take relationships for granted—
    • Develop mutual respect and trust, communicate effectively, give/receive positive and negative feedback; manage group dynamics
  • Actively listen to diverse perspectives
  • View and use constructive conflict as a positive means for—
    •  Asking thoughtful questions
    • Solving problems
    • Gaining consensus on complex issues
  • Act with honesty and integrity
  • Use disappointment as an opportunity to learn and improve collaboration