TABLE 5-1 Application of Best Practices to Collaboration Among Health Care Organizations: Technical and People-Focused Leadership Tasks

Technical Leadership Tasks Best Practices
Plans and protocols for change are needed to manage complexity and are needed (see Box 5-2 [Box D-1 in Appendix D]) Blueprints promote due diligence and effective decision making by leaders of change (e.g., conducting thorough premerger assessment of potential partners)
Technical capacity building Investment (time, money) is needed to build capacity for improved performance
Structures and systems to support change Structures (especially incentives) and systems (especially information systems) are needed to promote change and to improve organizational performance
People-Focused Leadership Tasks
External pressure In most cases, external pressure/support for change increases both its speed and likelihood of success
Buy-in from all levels; critical role of central authority and shared vision Support from top managers and leaders is essential, but buy-in is also needed from lower-level staff; a centralized group with authority for implementation of changes is critical, especially to develop a shared vision and goals for change
Communication Communication is needed at all levels: What is the vision; why change is needed; what progress has been achieved
Role of physician leaders Involvement of physician leaders, both formal and informal, in key decisions is critical to success
Managing tensions, trade-offs inherent in change Involving physicians versus respecting their time for patient care; time needed to build trust versus frustration with slow progress; building stakeholder buy-in versus building technical capacity (especially when buy-in and trust are enhanced by demonstrated technical capacity and improved performance)
Core versus peripheral organizational features Change in peripheral features of organizations, including management and support services, is easier to achieve than change in either core clinical services or organizational culture

SOURCE: D’Aunno et al., 2012.

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