Roundtable 2023 Program

Facilitators: Christina Yuan (Johns Hopkins University) and Birgitte Toring (Act2Learn)

Integrating Network Theory into the Study of Integrated Healthcare

Ingrid Nembhard (The Wharton School, University of Pennsylvania), Lawton R. Burns (The Wharton School, University of Pennsylvania) and Stephen Shortell (University of California, Berkeley)

Strengthening Networks for Youth to Adult Mental Health Transitions: A Multi-Level Intervention

Richard Wylde (National Health Service), Claire Kenwood (National Health Service), Eddie Devine (National Health Service), Heba Naim Ali (Brandeis University, RC Analytics) and Jody Hoffer Gittell (Brandeis University)

Relational Coordination and Social Network Analysis in Defining Relationships in the Operating Room

Kent Haythorn (Scripps Health)

Social System Mapping and Relational Coordination: Theory and Practice for Resiliency

Jim Best (Independent Consultant)

Facilitators: Wale Olaleye (Deloitte Human Capital; Brandeis University) and Vanessa Hurley (Georgetown University)

Digital Technology, Human Relationships and Work: Who Will Determine What the Future Will Be?

Erik Nicholson (Pandion Strategies) and Alexia Estrada (Semillero de Ideas)

Human-AI Interdependence in Post-Digital Organizations: Understanding the Role of Human Autonomy in an AI Mediated World

Kartik Trivedi (Brandeis University)

Impact of Secure Messaging on Health Equity and Type 2 Diabetes Outcomes During The COVID-19 Pandemic

Ben Kragen (The Carsey Institute, University of New Hampshire)

Revealing Interdependencies: Overcoming Data Sharing Barriers to Build a Relational Ecosystem

Ina Sebastian (MIT Center for Information Systems Research), Nils Fonstad (MIT Center for Information Systems Research) and Thomas Haskamp (Hasso Plattner Institute at University of Potsdam)

Facilitator: Bethlyn Gerard (Southwestern Health Resources) and Kartik Trivedi (Brandeis University)

Improving Relational Coordination in a Regional Triage Program at Atrius Health

Daniel Slater (Atrius Health)

Shared Care: CF Referral and Transplant Programs Improving Communication, Relationships and Systems of Shared Care

Marjorie M. Godfrey (University of New Hampshire) and Christian Merlo (Johns Hopkins University)

Disseminating and Sustaining Relational Coordination in the Veterans Health Administration

Brigid Connelly (Denver/Seattle Center of Innovation, Veterans Health Administration) and Heather Gilmartin (Denver/Seattle Center of Innovation, Veterans Health Administration)

Baseline Relational Coordination Prior to Implementation of Reflex Genomic Testing in an Academic Cancer Center: A Mixed Methods Approach to RC Diagnostics

Shellie D. Ellis, Zseraldina Ferenczi, Caroline Caine, Sam Boyd, Whitney Onasch, Chao Huang, Joaquina Baranda, Rashna Madan, Daniel Farrell, Heather Nelson Brantley, Aaron Katz, Matthew Lineberry, Andrew K. Godwin (University of Kansas Medical Center) and Jody Hoffer Gittell (Brandeis University)

Facilitators: Tony Suchman (Relationship Centered Health Care) and Cecile Foshee (Cleveland Clinic)

Knowledge Translation across Boundaries: Translation Strategies for Converting Scholarly Knowledge to Practitioner-Oriented Insights

Isabelle Yi Ren, Montclair State University; Jean Bartunek, Boston College; Mara Cable, Boston College

Relational and Structural Components of Innovativeness Across Academia and Practice for Progress Scale (IA-APPS)

Lindell Joseph (University of Iowa College of Nursing) and Michele Williams (University of Iowa)

The Development and Application of Relational Facilitation in the Veterans Health Administration

Heidi Sjoberg, Brigid Connelly, Brianne Morgan, Rachael Kenney, Catherine Battaglia and Heather Gilmartin (Denver/Seattle Center of Innovation, Veterans Health Administration)

The Good, Bad, and Indifferent: Landlord Logics and the Institution of Low-Income Private Rental Housing

Anna Perlmutter (Case Western Reserve University) and Scott Kroehle (Cleveland Housing Solutions)

Facilitators: Alice Andrews (Dell Medical School; Geisel School of Medicine, Dartmouth Hitchcock) and Aoife McDermott (Cardiff University; University of California Berkeley)

Finding Joy in Work: Lessons from High Performing Healthcare Teams

Heather M. Gilmartin (Denver/Seattle Center of Innovation, Veterans Health Administration), Brigid Connelly, Denver/Seattle Center of Innovation, Veterans Health Administration) and Catherine Battaglia (Denver/Seattle Center of Innovation, Veterans Health Administration)

Relational Coordination Among Care Providers in Canadian Long-Term Care Homes

Lisa Cranley (University of Toronto), Whitney Berta (University of Toronto) and Daniyal Zuberi (University of Toronto)

Relational Coordination: A Valid Tool for Addressing Nursing Faculty Moral Distress

Teresa M. Stephens (RN P.R.E.P.)

Relationships: The "Secret Sauce" in Building Resilient Academic Teams

Teresa M. Stephens (RN P.R.E.P.)

Facilitators: John Paul Stephens (Case Western Reserve) and Theodore "Jack" Iwashyna (Johns Hopkins School of Medicine)

Adaptive and Resilient Organizations: The Role of Senior Leaders In Developing High RC Organizations

Carsten Hornstrup (Joint Action Analytics)

Using the Relational Coordination Framework to Strengthen Networks for Integrated Equitable Healthcare and Social Care Systems in Canada

Grace Liu (York University) and Peter Tsasis (York University)

Understanding How Relationships Influence the Implementation of Complementary and Integrative Health Therapies in Whole Health Systems

Rendelle Bolton (US Veterans Health Administration)

Relational Coordination in a VA Medical Center Engaged in Transformation to a High Reliability Organization

Samuel Edwards (VA Portland Health Care System / RELATE Lab OHSU), Avery Laliberte (VA Portland Health Care System), Brian Park (RELATE Lab OHSU) and Martha Gerrity (VA Portland Health Care System)

Local Innovations - Unlock the Power of Data for Public Good

Amy Edwards Holmes (Executive Director, Bloomberg Center for Government Excellence, Johns Hopkins University). Join the Bloomberg Center for Government Excellence at Johns Hopkins University to discover how we use math, statistics, and coding to support governments with data, insights, and science translation to make informed decisions. We will facilitate a tour across our most relevant projects and demo tools we have developed for data democratization through engaging visualizations. Additionally, we will share insights into our work process to find stories in the data and translate them into meaningful and usable information.

Epistemology of Net Zero: Reimagining our Climate and Energy Worlds Beyond 2035

John W. Ballantine (Brandeis University)

Understanding Organizational Ideology: An Examination of Leadership Behavioral Responses to Polarization in So Called Nonpartisan Federal Institutions

Abdullah H. Clark (National Defense University, George Washington University)

Strategies and Initiatives to Enhance Rural Maternal Health

Chinue Uecker (LPI Consultants, SEI, Cornell, The Chicago School); Danita Richardson (The Chicago School)

Uncharted Territory: Exploring Long-Term Peer Coaching Groups as a Tool for Leader Development

Roman Terekhin (Case Western Reserve University)

Enhancing Teamwork Through a Relational Coordination Training Intervention in the Intensive Care Unit: A Pilot Study

Sherita House (University of North Carolina Greensboro), Hebatallah Naim Ali (Brandeis University), Cindy Bacon (University of North Carolina Greensboro) and Christopher Stucky (Landstuhl Regional Medical Center)

Intervening to Strengthen Relational Coordination in User-Centered Models of Service Delivery

Lauren Hajjar (Suffolk University), Hebatallah Naim Ali (Brandeis University), Jody Hoffer Gittell (Brandeis University) and Monica Higgins (Harvard Graduate School of Education)

An Exploration of Culture, Health, and Wellness of Costa Rica's Migrant Workers

Danita Richardson (The Chicago School), Mehreen Khan (The Chicago School), Chinue Uecker (LPI Consultants, SEI, Cornell, The Chicago School) and Marianne Jankowski (The Chicago School)

Facilitators: Kathie Sutcliffe (Johns Hopkins University) and Casey Heely (Brandeis University)

Hospital Observation Services with Rapid Rounding: Managing Uncertainty in Workflow through Relational Coordination

Paulo J. Gomes (Florida International University), Tala Mirzaeim (Florida International University, Baptist Health System) and Raphael Yonemura (Baptist Health System)

Applying Relational Coordination to Strengthen Interdependence Among Health Care Team Members During Bedside Rounding

Dorna Hairston (Johns Hopkins Hospital Office of Nursing Professional Practice), Ginger Hanson (Johns Hopkins School of Nursing) Kathy McDonald (Johns Hopkins University), Elizabeth Tanner (Johns Hopkins School of Nursing and School of Medicine), Anping Xie (Armstrong Institute for Patient Safety and Quality), Mona Bahouth (Johns Hopkins School of Medicine) Tenise Shakes (Johns Hopkins Hospital), Erin Blakeney (University of Washington School of Nursing), Rachel Salas (Johns Hopkins School of Medicine) and Bryan Hansen (Johns Hopkins School of Nursing)

How Do Hospitalized Patients with a Diagnosis of Advanced Heart Failure Perceive Relational Coordination with their Inpatient Care Team? Preliminary Results from an Ongoing Study

Erin Blakeney (University of Washington), Brenda Zierler (University of Washington) and Giovanna Abraham (University of Washington)

Creating a Relational Playbook for Cardiology Teams to Enhance Employee Well-Being and Veteran Care

Heather Gilmartin (Denver/Seattle Center of Innovation, VA Eastern Colorado Healthcare System), Brigid Connelly (Denver/Seattle Center of Innovation, VA Eastern Colorado Healthcare System), Edward Hess (Denver/Seattle Center of Innovation, VA Eastern Colorado Healthcare System), Candice Mueller (Veterans Health Administration), Meg Plomondon (Veterans Health Administration), Stephen Waldo (Veterans Health Administration) and Catherine Battaglia (Veterans Health Administration)

Facilitators: Roman Terekhin (Case Western Reserve University) and Jill Marsteller (Bloomberg School of Public Health, Johns Hopkins University)

Leadership, Relational Coordination, and Child Care Quality Improvement

Anne Douglass (University of Massachusetts Boston)

Leadership Development in an NGO Using Relational Coordination

Jonas Hedegaard (Team WorkingLife)

How COVID-19 Hit Healthcare Twice: The Role of Agile Leadership

Danita Richardson (The Chicago School), Freimut Juengling (University of Alberta Cross Cancer Institute), Chinue Uecker (LPI Consultants, SEI, Cornell, The Chicago School)

Managing by Relating: Understanding Professional Management of Hospital Executives Under New Medical Reform in China

Qian Zhang (University of Ottawa), Hao Gong (University College London), Hangzhou Ruilian (Zhitong Healthcare Management Consulting), Cheng Huang (Shanghai Jiao Tong University) and Ge Shi (Xinhua Hospital and Shanghai Jiao Tong University)

Facilitators: Wale Olaleye (Brandeis University, Deloitte Human Capital) and Jody Hoffer Gittell (Brandeis University)

Relational coordination began as a theory for understanding how people coordinate their work through relationships, and how the quality of these relationships impact performance outcomes (Gittell, 1995; Gittell, 2009). In the past ten years, relational coordination theory has evolved into the Relational Model of Organizational Change developed with colleagues in the US and around the world (Gittell, 2016). Informed by this model, multiple interventions have been carried out, some of which have been published (e.g. Suchman, et al, 2011; Perloff, et al, 2017; Blakeney, et al, 2019; Hajjar, et al, 2020; Blakeney, et al, 2021; Thygeson, et al, 2021; Olaleye, 2022; Warfield, et al, 2022; House, et al, 2023).

In this workshop we will introduce the Relational Model of Organizational Change, and focus on how to design relational, structural and work process interventions.  As facilitators, we will draw upon our experiences working in partnership with health systems, for example the Relating Across Difference intervention developed with Cleveland Clinic. We will start by introducing general principles of intervention design, then specific principles of designing interventions to strengthen relational coordination with attention to both equity and performance. Participants will work in small groups to design interventions for their own context, using tools from the Relational Coordination Playbook, with coaching from facilitators and from their peers. 

Facilitators: Marjorie M. Godfrey (IEHSS, University of New Hampshire) and Tanya Allain (IEHSS, University of New Hampshire)

 This highly interactive workshop will share a multi-system level model of improvement centered around patients and families to co-produce "pathways" of care between two or more microsystems. Participants will be able to utilize several case studies to practice activities of the transition model of care from assessing current context and performance, coaching relational mapping and RC survey administration, analysis and reporting, adapting field tested interventions to improve communication and relationships and develop leadership to advocate and support the improvement of patient centered pathways across multiple contexts of care delivery. Key relationship building strategies, essential processes of care delivery and increasing shared knowledge of each context of care delivery with a shared vision will be highlighted. Each participant will complete the session with an action plan. OF NOTE: Participants may bring their own "pathway" information and data to focus the workshop on to develop a clear action plan for when they return to their own practice.

Facilitators: Alexandra Suchman (Barometer XP) and Tony Suchman (Relationship-Centered Health Care)

As awareness of relational coordination continues to grow rapidly, so does interest in relational interventions. New approaches are needed to categorize relational interventions and help consultants, leaders and/or managers choose interventions for their particular situations or needs. We describe a new tool for this purpose called the Pressure Matrix. The Pressure Matrix is a nine cell grid that characterizes how people experience their work environment and how integrally connected individuals’ experiences are to the overall health of the team and organization. Although its terminology is different, the Pressure Matrix includes elements of Relational Coordination (shared goals, mutual respect, effective communication) The nine dimensions are organized along two axes. - The columns reflect three dimensions of how individuals experience and engage in their work: Feel, Think, and (Re)Act. - The rows reflect three dimensions of how the organization’s work is conceptualized and executed: Why (related to purpose and values), What (related to strategy and metrics), and How (related to process). - Each cell represents the domains or activities that sit at the intersection of one individual and one organizational dimension. For instance, the cell “Identity and Belonging” characterizes the intersection of Feel (individual level) with Why (organizational level).”Growth and Development” sits at the intersection of Think and What; “Tools and Capacity” represents the intersection of (Re)Act and How. The Pressure Reading is a survey comprised of questions that assess each of the 9 cells. It can be completed by the team leader or all the team members. The pattern of results highlights strengths and pressure points within the team.

Each cell has associated game-based interventions that promote learning and development for that particular function or domain, so the Pressure Matrix serves as a catalog of interventions, guiding leaders or to consultants to the most relevant interventions for a given pattern of survey results. For example, the cell Identity and Belonging reflects the extent to which individual team members feel safe to show up authentically at work, feel like they are a vital part of a larger whole, and feel that their work contributes to the overall mission and impact of the organization. When Identity and Belonging is strong, individuals feel connected and motivated both as individual contributors and as a group unified by its shared commitment. If a team is looking to foster a stronger sense of Identity and Belonging, the Pressure Matrix suggests a game called Scavenger Hunt that involves personal storytelling to give colleagues an opportunity to get to know each other better and learn about each other’s unique strengths and experiences. In this presentation we will describe the Pressure Matrix in greater detail and share case studies showing how it has been used to help teams take stock and plan interventions. We will also discuss plans for future research and application.

Facilitators: Masami Tabata Kelly (Brandeis University) and Njoke Thomas (Boston College)

Identity Disclosure as a Relational Intervention

Ryan Scott Teschner (University of Texas at Dallas) and John W. Lynch (University of Illinois at Chicago)

Enhancing Gender Equity in Workplace Relationships: The Impact of Expressing Gratitude and Top Management Gender Diversity

Hun Whee Lee (Ohio State University), Dorian Boncoeur (University of Notre Dame), Joanna Lin (University of Georgia) and Brent Scott (Michigan State University)

Relating Across Difference: An Improvement Process for Clinical Teams at Cleveland Clinic

Cecile Foshee (Cleveland Clinic), Jody Hoffer Gittell (Brandeis University), Aanchal Kapoor (Cleveland Clinic), Olawale Olaleye (Brandeis University, Deloitte Human Capital), Tyler Reimschisel (Cleveland Clinic), Tony Suchman (Relationship Centered Health Care), and Chiedozie Udeh (Cleveland Clinic)

Community Health Workers Advance Equity and Violence Prevention Through Relationships and Readiness for Change

Rumana Shams Rabbani (UNC Chapel Hill, CHASM), Abdul Hafeedh bin Abdullah, CHASM), Lauren Hajjar (Suffolk University), Abraham Wandersman (The Wandersman Center), Brittany Cook (The Wandersman Center), Jennifer Perloff (The Heller School, Brandeis University) and Jody Hoffer Gittell (The Heller School, Brandeis University)

Facilitator: Krista Hirschmann (Enhance Communication)

Gittell and Fletcher’s article on Integrative Solutions in a Divided World highlights Jean Baker Miller’s paradigm shift of human development from individuation to “increasing proficiency in relating with others."  Inspired by these ideas, this workshop will explore the tension between structural priorities and intervention design. On the surface, I am an external coach asked to “improve team dynamics” in a Bariatric Medicine practice that is part of a large academic health network, which spans 13 hospital campuses. The practice context is not entirely unique to the network or healthcare in general. They were post COVID, short on staff, had turned over 3 Practice Managers (2 during the time of my involvement) did not have a Medical Director or readily available leadership, suffered from other examples of role clarity, and were going through series of programmatic changes, just to name a few challenges. Time spent with the team in both 1:1 conversations, observations, and a few structured workshops revealed an important pattern over 18 months of intermittent interaction.

While relational coordination provided a useful framework to facilitate immediate team dynamics, progress was painfully hampered and delayed by seemingly two unrelated factors: 1. Low level of readiness 2. Logistical complexity of availability In the case of readiness, it is easy to think (by myself and others) that specific personalities are being “resistant,” or are not “self-aware.” Likewise, issues with logistical complexity, or simply finding time to meet, led to language of “competing priorities,” “being overwhelmed,” and the ultimate card--protecting clinical schedules and patient access. In fact, however, these two barriers are deeply interrelated and manifested in the questions posed by Gittell and Fletcher. Specifically, they reflect on the social and organizational prioritization of relational skills, particularly as it relates to leadership and power. Furthermore, they reflect the fractal nature and self-similarity of relational systems, notably illustrated by identical complaints from both executive leaders and frontline staff longing for more connection, communication, and collaboration with colleagues and leaders.

In this case, the structural dynamics of the organization and health care at large privilege the visible clinical work over the invisible relational work. While it might seem wildly counterintuitive to flip this paradigm in a healthcare setting, doing so acknowledges that the clinical work is built on and driven by relational dynamics. Until there is a shared cultural norm that says “fix the relationship first” rather than “if you have a chance,” all people in the system and outcomes will suffer. In this workshop we will explore specific micro and macro examples (including one viral situation) of these patterns at play throughout the network.  Participants will share similar situations they have faced, and together we will develop solutions for how to address these dynamics when they arise.

Facilitator: Jim Best (Independent Consultant)

Social System Mapping is a tool that can support a community wanting to build resilience for itself. The self-awareness can amplify and stimulate a more robust, connected, relationally rich, information-sharing, regenerative, learning, innovative, self-organizing, and playful community. The RCC Community Building Innovation Lab is experimenting with a Social System Map that enables the kind of collective and individual self-awareness that fuels those outcomes. This is a hands-on, laptop tutorial. At the end of it you will know: – what a Social System Map is – a mashup of other maps you may be familiar with (asset map, social network map, systems map, etc.) – how to use it as a visual directory of RCC map participants – how to put yourself on the map (or take yourself off) – how to update the connections you make at this Roundtable and after – how to navigate the map views, filter, cluster, showcase, and focus on aspects of the community to help you make sense of how the RCC is relationally organized and evolving – how this is useful for connecting yourself to the rich human resources in the RCC – why this mapping can enable us to begin to shift our perspective from an individual mindset to a network or relational mindset – and why this shift is important to building capacity through the connective tissue of a resilient, regenerative community.

As we move through the tutorial and the map builds before our eyes we’ll explore the map views and talk about what we notice. Then we’ll use it to find others in the community that you might want to build relationships with at some point. Finally, we’ll explore together what might be useful information to include on the map that isn’t there now and how that might serve our collective purpose. Participants will come away with a richer and new way to view the RCC community and a tool to connect and build relationships “Beyond the Roundtable” in the year ahead.

Facilitators: Jane Cooper-Driver (Intend Health Strategies) and Jennifer Agwagom (Geisinger Commonwealth School of Medicine)

Structural inequities exist for patients and team members in all aspects of healthcare, and they are a significant barrier to creating interdependent networks. They also prohibit connection among team members who have diverse professional and social identities. We need effective strategies to address these inequities, and one approach is relational leadership (RL). RL is a human-centered approach to working with others that cultivates connection and awareness to increase belonging, collaboration, equity, and impact across health systems. RL is vital for care teams to lead change and advance diversity, equity, inclusion, and accessibility. This workshop will introduce participants to RL core practices to advance self-awareness, enhance connection with others, and deepen a sense of purpose. People are multi-faceted, and workshop participants will explore their identities and positionality.

Workshop participants will be given time to self-reflect on various aspects of their identities, how those components are interconnected, and what part of their identity is visible to others. They will discuss in small groups what the self-reflection exercise was like for them, how identity and positionality impact their current teams, and how increased awareness could build relationships and lead to interdependence. Participants will learn about and explore their sources of power. Self-awareness includes knowing how our identity impacts our biases and informs our interactions with others, including how we wield power. Addressing power dynamics can advance equity by re-distributing power in our practices, creating opportunities for input and decision-making for all members of the team. Participants will discuss how a “power with” approach is or could be used on their teams in small groups. Interprofessional healthcare teams must learn RL skills to enhance trust and engagement. If teams do not incorporate a relational mindset, they risk constraining improvement efforts, increasing workforce burnout, and preventing interdependent collaboration. Additionally, power imbalances can impede team-based care, leading to poorer quality and suboptimal clinical outcomes.