The Heller School for Social Policy and Management
Relational Coordination Collaborative

Strengthening Networks for Equitable and Integrated Healthcare

Relational mapping at UCSF Medical CenterIt is increasingly apparent that success in a highly interdependent world depends on identifying and strengthening the networks through which value is created (Adner & Kapoor, 2010).  These networks often span multiple organizations and multiple levels - from leadership networks, to networks across the workgroups engaged in value creation, to client-centered networks at the site of value creation. Achieving desired performance outcomes requires the ability to identify, analyze and strengthen these networks.  

For example, the move towards value-based healthcare has increasingly shined a light on the importance of social factors, such as safe housing, adequate food and adequate financial resources, for impacting patients’ health and well-being (Mays, Mamaril & Timsina, 2016). Population health initiatives such as accountable care organizations have tremendous potential to reallocate resources from acute medical care to prevention and social services (Fisher et al, 2012; Lewis et al, 2017). As the definition of care and the locus of control begins to shift towards the joint production of health, community actors such as departments of public health also have a role to play. However, there are very few models for how these disparate sectors can work together to reduce health inequities. 

While structures are necessary for healthcare integration, they are likely not sufficient (Burns, Nembhard & Shortell, 2022). Relationships are a key ingredient of effective coordination when actors are highly interdependent and when they are carrying out work characterized by high levels of uncertainty and time constraints (Gittell, 2002; Faraj & Xiao, 2006; Okhuysen & Bechky, 2009; Singer, et al, 2011).  Relational coordination is the coordination of work through relationships of shared goals, shared knowledge and mutual respect, supported by frequent, timely, accurate, problem solving communication in the context of interdependence, uncertainty and time constraints (Bolton, Logan & Gittell, 2021). While this theory has often been applied within organizations, it can be expanded to address cross-organizational (Gittell & Weiss, 2004) and cross-sectoral coordination (Caldwell, Roehrich & George, 2017), as well as coordination with patients and families (Warfield, et al, 2013; Cramm & Nieboer, 2016).   Likewise, recent research suggests that integrating this theory with social network theory and analysis is likely to generate insights and strategies that enable multi-level improvement in healthcare integration (Burns, Nembhard & Shortell. 2022; Gittell & Ali, 2021).

We invite you to join this Innovation Lab on Strengthening Networks for Equitable and Integrated Healthcare.   It is a large umbrella with multiple projects underway, and more to come.

Project:  Relating Across Difference - An Improvement Process for Clinical Units

Project:  Relational Coordination in the Veterans Health Administration 

Resources

Academy of Management Workshop:  McDonald, K. & Nembhard, I. (2023).  Strengthening networks for equitable and integrated healthcare.  AOM Annual Meetings.

Published Article:  Burns, L. R., Nembhard, I. M., & Shortell, S. M. (2022). Integrating network theory into the study of integrated healthcare. Social Science & Medicine, 296, 114664.

Join This Innovation Lab

manage  your member account to join up to three  innovation labsFounding Members

Kathy McDonald

Bloomberg Distinguished Professor, Johns Hopkins University

Patient-safety expert Kathryn McDonald explores what makes for safe, affordable, and high-quality health care delivery systems and the factors that prevent health organizations from achieving that standard of care. Her research relies on close partnerships with frontline teams, including patients and families. As the Bloomberg Distinguished Professor of Health Systems, Quality and Safety, Dr. McDonald holds primary appointments in the Schools of Medicine and Nursing and joint appointments in the Carey Business School and Bloomberg School of Public Health. Dr. McDonald also has affiliations with the Malone Center for Engineering in Healthcare, the Armstrong Institute for Patient Safety and Quality, and Hopkins Business of Health Initiative. Before joining Johns Hopkins, Dr. McDonald was founding executive director of the Center for Primary Care and Outcomes Research at Stanford University’s School of Medicine and executive director of Stanford’s Center for Health Policy.

Olawale Olaleye

Co-Principal Investigator, Relating Across Differences; Consultant, Deloitte

Wale Olaleye is a Pharmacist, a Human Capital Consultant for Deloitte, and a Postdoctoral Fellow at The Heller School for Social Policy and Management at Brandeis University.  He serves as Co-Principal Investigator on Relating Across Differences - An Improvement Process for Clinical Units, funded by the Josiah Macy Foundation, implementing the results of his research in three U.S. health systems over a three-year period.   He received his PhD in Social Policy at The Heller School, an MBA with a focus on Health Systems Management from the Charlton College of Business at the University of Massachusetts Dartmouth, and his Pharmacy degree from the University of Ibadan Nigeria.

Dr. Olaleye studied interprofessional teams at Beth Israel Lahey Medical Center in Boston where he identified workforce diversity as an impediment to effective communication and relationship building between and within teams. His dissertation focused on the use of Relational Coordination principles to uncover professional and social identity-related discrimination on health care teams.  Prior to joining the Heller School, he worked at Steward Health Care System of Massachusetts and Care New England Corporate of Rhode Island as a Hospital Manager. He has also worked as a Clinical Pharmacist at government-owned hospitals in Abuja, Nigeria. His research interests include team-based care, diversity equity and belonging, opioid policy, performance of healthcare organizations and issues related to the healthcare workforce. 

Masami Tabata-Kelly

Masami Tabata-Kelly

Doctoral Candidate, Brandeis University; Health Services Researcher, Senior Project Manager, Brigham and Women's Hospital

Masami Tabata-Kelly is a doctoral candidate studying health policy at the Heller School for Social Policy and Management at Brandeis University. She has served as the senior project manager at the Center for Surgery and Public Health and the Center for Geriatric Surgery at Brigham and Women’s Hospital. In this role, Ms. Tabata-Kelly successfully led interdisciplinary teams of clinician scientists in conducting health services research projects, specifically focused on improving surgical outcomes for older adults with serious illnesses.

Ms. Tabata-Kelly is deeply committed to advancing equity and justice in serious illness care by strengthening and diversifying the healthcare workforce that is equitable, thriving, healthy. She aims to generate robust evidence from a health equity perspective to support the development and implementations of healthcare workforce policies. Ms. Tabata-Kelly earned her MBA from Quantic School of Business and Technology, her MA in medical anthropology from Boston University School of Medicine, and her BA in cultural anthropology from the University of California, Los Angeles.

Christina Yuan

Assistant Professor of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine

Christina T. Yuan, PhD, MPH is an Assistant Professor of Anesthesiology and Critical Care Medicine at the Johns Hopkins School of Medicine, with a joint appointment in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

Her research focuses on the dissemination and implementation of healthcare innovations, with a special interest in how healthcare providers influence and learn from one another. Through the use of qualitative, quantitative, and social network methods, she is currently studying the implementation of enhanced recovery after surgery programs, the meaning of patient safety in patient-centered medical homes, and the role of social networks in the implementation of electronic health records.

Dr. Yuan received her Ph.D. in Health Policy and Management, with a concentration in Organizational Theory and Management from Yale University. She received her M.P.H in the Epidemiology of Microbial Diseases from the Yale School of Public Health, and her B.S. in Biology and Honors from Villanova University.

Dr. Yuan’s work appears in several peer-reviewed outlets, including JAMA Surgery, Health Services Research, Health Care Management Review, and The Joint Commission Journal on Quality and Patient Safety.