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Four lessons for running impactful collaboratives in health care

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The below content is taken from Jo Bibby's (Director of Strategy at the Health Foundation) article on the Health Foundation Blog. A link to the original article can be found at the bottom of the page.

As one would expect, there is no single unequivocal answer, but by reviewing the existing literature it is possible to identify some factors that are common to those collaboratives that appear to have had the greatest impact. Four lessons emerge:

  • Involve the right people. Collaboratives are turbo-charged by discretionary effort and social capital. They work best when they are voluntary, inclusive (of all disciplines and patients) and in an environment where teams have senior support to make change.
  • Pick the right problem. Collaboratives work best on issues where there is consensus on the problem and solution, and where teams can get traction. They are most likely to show results when there is a large gap to be closed between actual and desired practice, and tight coupling between the defect and the solution.
  • Organise, organise, and adapt. Good collaboratives embody discipline through: working to the same goals and timelines; using standardised, evidence-based interventions; and embedding the necessary change skills and maximising connectivity. But the role context plays in implementing a successful intervention cannot be ignored - teams need to be given freedom on the ‘how’ of what they implement.
  • Recognise and provide the necessary resources. While the enthusiasm and passion generated through shared endeavour can take teams a long way, you need a realistic assessment of the time and resources needed to support effective measurement and time for reflective learning.

If these then are the conditions for a successful collaborative, what does it tell us about when a collaborative model isn’t likely to work and what other approaches exist? From my own experience I would offer the following observations:

  • Don’t assume people know the basic quality improvement methods needed to measure, test and study changes. Do a skills audit and make sure you have the right expertise in teams before you start.
  • Don’t be over-ambitious. The real legacy of collaboratives is the mindset they cultivate that change and improvement are possible. Set realistic goals to build a sense of success and confidence.
  • Don’t expect collaboratives to address systemic problems. System-level issues will only be addressed with the necessary leadership from the top.
  • Don’t expect it to work everywhere, every time. The context for health care delivery can vary considerably – the same solution won’t always get the same results. Rather than seeing this as failure, use it as an opportunity to learn.

Original Article

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