MHA 542 Week 5 Meaningful Collaboration in the Health Sector Example

Collaborating With the Hospital Across Town: A Shared Crisis Center, Surgical Team Training and What Makes Collaboration Meaningful Rather Than Ceremonial

[Student Name]

University of Phoenix

MHA/542: Leading with Authenticity in the Health Sector

Week 5 Assignment

[Instructor Name]

[Date]

The medical center, its rival hospital, the crisis center and the team training program are composites written for a model paper; research findings come from the sources cited.

In February, the county's community mental health director met the chief operating officer of a composite western Michigan medical center and her counterpart at the rival hospital across town. Both emergency departments were holding patients in mental health crisis for days, waiting for psychiatric beds. The director proposed that the two hospitals and the county jointly fund a crisis center. At the same time, inside the medical center, surgical leaders were preparing a team training program after a near miss in the operating room. This paper examines what made both efforts meaningful collaboration.

Collaboration, Not Coordination

Coordination aligns activities that remain separate: two hospitals agree on transfer procedures. Collaboration goes further. Partners share goals, decisions and risk, and each changes how it works to achieve a result neither could reach alone. Meetings and committees can support collaboration, but they are not the same thing.

Barriers

The chief operating officer named the barriers honestly. Between the hospitals: competition for patients and physicians, a history of mistrust and different information systems. Inside the operating room: professional hierarchy, time pressure and the habit of each discipline working in its own lane.

The Crisis Center Partnership

The partners agreed on a shared goal: no patient in mental health crisis should wait more than 12 hours in either emergency department. The crisis center, run by the county's mental health agency, offers 24-hour walk-in and ambulance access, observation for up to 23 hours and connections to follow-up care. Each hospital contributes $900,000 a year, and the county contributes staff and a building.

Sharing Decisions and Risk

A governing committee with equal representation from both hospitals and the county makes decisions by consensus. The hospitals agreed to share emergency department boarding data monthly, something they had never done, and to split any operating shortfall in the first two years. Shared risk made the commitment real.

The Leader's Personal Role

The chief operating officer built trust with her counterpart through small acts: she shared her hospital's boarding data first, credited the other hospital publicly at the county board meeting and resisted pressure from her own marketing team to promote the center as her hospital's achievement.

Inside the Operating Room: Team Training

The near miss, in which a patient nearly received the wrong antibiotic because a nurse's concern was not heard, prompted a team training program for all surgical staff. The program teaches briefings before each case, debriefings after, structured communication and the expectation that anyone can stop a case to raise a concern.

Evidence for Team Training

A study of Veterans Health Administration facilities found that the 74 facilities that implemented a medical team training program saw an 18% reduction in annual surgical mortality, compared with a 7% decrease in 34 facilities that had not yet undergone training, with larger reductions for longer participation (Neily et al., 2010). Teaching surgical teams to talk before and after each case was associated with fewer deaths.

Why Shared Goals Matter

Studying joint replacement patients across nine hospitals, researchers linked relational coordination, meaning communication that is frequent, timely, accurate and aimed at solving problems, backed by common aims, common understanding of each other's work and respect across roles, with better care quality, less pain after surgery and shorter stays (Gittell et al., 2000). The briefings and debriefings create routines in which that kind of communication happens every day.

Being Honest About the Evidence

Not all claims about collaboration are proven. A Cochrane team pooled nine trials of efforts to strengthen teamwork across professions and concluded that some, such as externally facilitated team activities, may slightly improve outcomes such as functional status after stroke and adherence to recommended practices, but rated much of the evidence as low or very low certainty (Reeves et al., 2017). Leaders should promote collaboration with enthusiasm and measure it with humility.

When Collaboration Nearly Failed

In the crisis center's third month, the rival hospital began sending patients whose main problem was intoxication rather than mental health crisis, which strained the center's staff. The medical center's emergency physicians complained that their partner was using the center to offload difficult patients. Rather than escalating, the two chief operating officers reviewed the data together, found that both hospitals had sent such patients and agreed on shared criteria with the county. The dispute tested the partnership and, handled openly, strengthened it.

Resistance in the Operating Room

Not every surgeon welcomed briefings. Two considered them a waste of time for routine cases. The chief of surgery asked them to try briefings for a month and to track how often something useful came up. One surgeon found that briefings caught missing equipment or unclear plans in about one case in five and became an advocate. Collaboration spread more through experience than through instruction.

Collaboration With Patients and Families

Meaningful collaboration includes the people being served. The crisis center's governing committee added two members with lived experience of mental illness, and the surgical team invited patients to confirm their procedure and concerns during the briefing before anesthesia, making them part of the team rather than its subject.

Principles for Meaningful Collaboration

Across both efforts, the chief operating officer identified principles. Start with a shared goal that matters to everyone. Share decisions, data and risk, not only information. Give up something, such as credit or control. Build routines that make collaboration daily work. Address hierarchy and competition directly. Measure the collaboration and its results.

Measures for the Crisis Center

Boarding hours for mental health patients in both emergency departments, crisis center visits, follow-up within seven days and partner satisfaction with the governance process are reviewed monthly.

Measures for Team Training

Briefing and debriefing completion, staff ratings of teamwork and speaking up, near-miss reports and surgical complications are reviewed quarterly.

Sustaining the Crisis Center

Partnerships that depend on the goodwill of two executives can collapse when either leaves. The partners wrote a five-year agreement setting out contributions, governance, data sharing and how disputes are resolved, and each hospital designated a second executive who attends governing committee meetings. The county sought state grant funding to reduce the hospitals' share over time.

Early Results

In the crisis center's first six months, average boarding for mental health patients fell from 41 hours to 14 in the medical center's emergency department and by a similar share at the rival hospital. Briefings occurred before 94% of surgical cases, and staff teamwork ratings rose.

Conclusion

Meaningful collaboration requires shared goals, decisions and risk, whether between rival hospitals or between a surgeon and a nurse. The crisis center showed that competitors can collaborate when leaders share data and credit. Team training, supported by evidence linking it to lower surgical mortality and by research on relational coordination, made collaboration part of daily surgical work. Honest attention to where the evidence is uncertain keeps leaders measuring whether collaboration delivers.

References

Gittell, J. H., Fairfield, K. M., Bierbaum, B., Head, W., Jackson, R., Kelly, M., Laskin, R., Lipson, S., Siliski, J., Thornhill, T., & Zuckerman, J. (2000). Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: A nine-hospital study of surgical patients. Medical Care, 38(8), 807-819. https://doi.org/10.1097/00005650-200008000-00005

Neily, J., Mills, P. D., Young-Xu, Y., Carney, B. T., West, P., Berger, D. H., Mazzia, L. M., Paull, D. E., & Bagian, J. P. (2010). Association between implementation of a medical team training program and surgical mortality. JAMA, 304(15), 1693-1700. https://doi.org/10.1001/jama.2010.1506

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2017(6), CD000072. https://doi.org/10.1002/14651858.CD000072.pub3