Collaboration

1
Collaboration

• Objectives
• To describe the evolution of the concept of
  collaboration
• To delineate the characteristics of collaboration
• To demonstrate the application of collaboration
  concept into practice

2
Collaboration

• Definition
• Working together for a common goals
• Pooling of resources and ideas within or across
  disciplines for innovation and problem-solving
  (CINAHL)
• Interaction of 2 or more persons or organizations
  directed toward a common goal which is mutually
  beneficial (MEDLINE, cooperative behavior)

3
Societal Shifts

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

4
TRENDS

• New organizations
• New forms of delivery systems-- managed care
• New ways of relating to each other
• Smaller companies

• 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

5
Changing Work Environment

• Technology
• Demographics
• Managed Care
• Purchasers Influence
• Health Insurance Industry
• Changing Health Systems
• Telemedicine

6
Managed Care Environment

• Focus on outcomes, research based practice
• High quality care
• Cost-effective interventions
• 2/3 with MH insurance are enrolled in managed
  care plans
• 4/5 of all states are implementing changes in
  Medicaid programs
• Responsible for widespread application of
  information technology

7
Telecommunications

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

8
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

9
Health Problems Needing Collaboration

• Mortality rates for persons with brain disorders
  are twice that of general population
• 50 have known medical disorders
• 35 have undiagnosed medical disorders
• One in five has a medical problem may cause or
  exacerbate psychiatric condition
• Increased risk CVD

10
Substance Abuse Problems Needing Collaboration

• 53 of drug abusers have at least 1 serious
  psychiatric problem
• 37 of alcohol abusers have at least 1 serious
  psychiatric problem

11
Surrogate Terms

• Joint practice -gt collaborative practice
• Shared governance people discuss, debate, and
  work from the same data base shared vision
• Coalition take joint action or resolve a
  mutually shared concern or reach a common goal

12
Related Concepts

• Cooperation mutual give take
• Collegial equal power or authority
• Working together intellectual endeavor
• Teamwork team approach
• Interdependence, - shared power/authority
• Professionalism antecedent
• Professional practice - consequence

13
Implications

• Patient care pts are the true beneficiaries
• Education 1st step in the learning strategy
• Research application of the findings
• Organization shared governance -gt better
  decisions regarding pt care

14
Partnership Attributes

• Respecting each other
• Communication
• Working together
• Partnership relationship
• Trusting each other

15
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

16
Characteristics

• Legitimacy /power sharing
• Individuals identity accountability
  relationship to overall power
• Self-knowledge
• Self-awareness future growth
• Respect
• Individual autonomy boundary
• Commitment
• Responsibility for goal attainment

17
Outcomes

• Increased access
• Improved quality
• Positive client outcomes
• Increased creative solutions
• Improved and increased human resources
• A more productive community
• Greater student achievement
• Job satisfaction

18
Outcomes (II)

• Education--meets service mission gains practice
  settings for faculty students
• Service--gains excitement of a learning
  environment
• Joint ventures
• research and demonstration projects
• develop models of practice

19
Essential elements in organizations readiness
for collaboration

• Compatible R among Drs Ns. common goal
  unique competencies
• Support from administration -gt quality care
• Clinically competent of the staff
• Collegial R
• Primary nursing
• Ns excellence is rewarded

20
high
Competition
Collaboration
assertiveness
Compromise
Avoidance
Accommodation
high
low
cooperation
2-dimensional grid of collaboration
21
The driving forces of successful collaboration
partnerships

• People -gt enliven
• Sharing of human resources
• Careful planning monitoring
• Communication understanding of goals purposes
• Time
• Relationship
• Skills
• Energy motivation
• Enthusiasm commitment

22
Transdisciplinary Collaboration Project
San Jose State University Office of Sponsored
Programs College of Applied Sciences and
Arts School of Nursing Nurse Managed
Centers Communication Disorders Sciences
Program Clinic Department of Occupational
Therapy Department of Recreation Leisure
Studies TR College of Social Work Institute for
Teaching Learning Faculty and Students Revised
5/99
Psychosocial. Occupational Therapy Clinic
Santa Clara County Mental Health
Santa Clara County Alliance for the Mentally Ill
ALLIANCE for Community Care Zoe House Crossroads
Village Casa Feliz
Residents Staff Families
23
Through collaborative efforts, provide quality,
cost effective services for persons with serious
mental illness living in the community while
simultaneously preparing future mental health
professionals for practice.
Project Goal
24
Behavioral Ecological Model of Community Mental
Health
Laws Administration of Justice
University Training of Professionals
Community Friends and Peers
Church Family
Person
Laws Mental Health System
Social Policy Legislation
25
Stress Management

• Nursing
• Crisis intervention
• Deep Breathing
• Self Talk
• Time out
• Visualization
• Prevention
• Diet nutrition
• Exercise
• Time management

• Communication Disorders
• Organizing and creating schedules
• Follow up on comprehension
• Routines
• Social Skills

26
Stress Management

• Therapeutic Recreation - Identify triggers -
  Identify practice strategies to manage
  stress - Example exercise, visualization,
  relaxation

• Occupational Therapy - Identify causes - Assess
  coping strategies - Environmental
  adaptations - Problem solving - Frustration
  tolerance - Therapeutic activity

27
Outcomes of Collaboration
Clearly, the closer educators, researchers,
consumers, practitioners, and families come
together in the service area, the more likely
that curricula will be reality based and
congruent with clients needs. At the same time,
the possibility of improving the quality of life
increases.