RELATIONAL COORDINATION is communicating and relating for the purpose of task integration - a powerful driver of performance when work is interdependent, uncertain and time constrained. With the RC Survey, a valid and reliable measurement tool supported by our partner Relational Coordination Analytics, you can gain new insight into the dynamics that exist between individuals, groups and organizations - and begin to transform them. When used for interventions, this measurement tool should be treated as one core element of a broader system, as shown in the Relational Model of Organizational Change, and with guidance from skilled practitioners.
RCRC’s mission is to transform relationships for high performance by helping organizations to build shared goals, shared knowledge and mutual respect across boundaries. We connect researchers and practitioners in an innovative, collaborative setting to develop and test new models of change. Together we help organizations transform the relational dynamics underlying their work processes and redesign their structures to support and sustain the new dynamics.
Dr. Marjorie Godfrey Receives American Academy of Nursing's Highest Honor
November 1, 2014
The American Academy of Nursing inducted 168 Fellows on October 18 including Marjorie Godfrey, RN, PhD. Margie is a valued RCRC board member and partner as well as founder and co-director of the Dartmouth Institute Microsystem Academy. The Academy's more than 2,100 members—known as fellows—are nursing's most accomplished leaders in education management, practice and research. Fellows include association executives; university presidents, chancellors, and deans; state and federal political appointees; hospital chief executives and vice presidents for nursing; nurse consultants; researchers; and entrepreneurs.
Fellows have been recognized for their extraordinary nursing careers and are among the nation's most highly-educated citizens: more than 90% hold doctoral degrees and the rest have completed masters programs. Invitation to the fellowship represents more than recognition of one's accomplishments within the nursing profession. Academy fellows also have a responsibility to contribute their time and energies to the Academy and to engage with other health leaders outside the Academy in transforming the health system.
Margie we are extremely proud of you for receiving this honor. We value the contributions you have made to creating change through microsystem coaching programs around the world - and your contributions to the theory and practice of relational coordination. See here for more about Margie.
Best Paper Award for Muhammad Siddique - High Performance Work Systems, Relational Coordination and Bank Performance
September 14, 2014
Student partner Muhammad Siddique (Newcastle University Business School) just won Best Paper for the Human Resource Management track in the British Academy of Management for his dissertation paper entitled: "Exploring the Linkages between High Performance Work Systems and Organizational Performance: The Role of Relational Coordination in the Banking Sector of Pakistan."
"This study sets out to determine the process through which high performance work systems (HPWS) affect organizational performance. Previous research in the field of HRM has mainly supported the view that properly designed high performance work systems can enhance organizational performance (e.g. Delery and Doty, 1996; Combs et al. 2006). There is a growing debate, however, with regard to understanding the process through which this HPWS influence takes place (Wright and Boswell, 2002; Boselie at al. 2005). Encouraged by considerable information on statistical associations between HPWS and improved organizational performance, researchers have shifted the focus towards understanding the “mechanism” linking HPWS and organizational performance (Guest, 2011; Boxall, 2012). This study also focuses on this area of research by examining the mediating role of relational coordination among employees. In general, researchers have highlighted the significance of the quality of HPWS implementation and its impact on performance from organizational perspectives. This study examines the effects of HPWS on performance from the perspectives of employees regarding their reactions to the implemented high performance work systems in the workplace (Liao et al. 2009)."
"Preliminary results of the multiple regression analysis have revealed that the extent of HPWS predicted relational coordination among employees at individual, functional and unit levels. The study has shown that there were significant differences between managerial and non- managerial employees’ perspectives of HPWS. There were also significant variations in employee perspectives of relational coordination among employees of different functions and among employees of the same functions."
"The analysis suggests that the extent of HPWS was significantly related to branch-level performance in the Pakistani banking sector. Results have shown that HPWS was significantly related to performance in terms of branch deposits, advances, and overall profitability. In terms of the linkages between relational coordination and performance, the findings suggested that relational coordination among employees was positively associated with various performance outcomes at the unit level. One of the more significant findings emerged from this study is that relational coordination partially mediated the relationships between HPWS and branch level performance. Consequently, the extent of HPWS was significantly related to branch growth in deposits, growth in advances, branch advances to deposits, and growth in profit through the mediation of relational coordination among employees."
Congratulations to Muhammad and to his co-author Professor Steven Procter - we hope to hear this work presented in our 2015 webinar series!
Relational Coordination and Collaborative Knowledge Creation - Webinar by Visiting Scholar Harold Alvarez
August 27, 2014
RCRC student partner, Brandeis visiting scholar and PhD candidate Harold Alvarez of Maastricht University in the Netherlands (Department of Organizations and Strategy) will present one paper from his dissertation by webinar on September 19 at 11:00 am ET. This webinar is intended especially for partners to hear the work of our student partners, with additional time from 12-12:30 pm for student partners only to discuss questions they are facing in their work.
"In many areas of work today, knowledge workers may no longer find themselves working alone or exclusively with members of their own knowledge specialization, but rather interacting with professionals from diverse disciplines and functional units to jointly create new or emergent knowledge to produce innovations. Under these circumstances, the dynamic relational process of collaborative knowledge creation might face specific challenges that may prevent the team from achieving the best possible results. Relational coordination (RC) (Gittell, 2002) is an emerging theory for understanding the relational dynamics underlying a work process. This research empirically investigates how RC can enable the process of collaborative knowledge creation to flourish. Using a cross-sectional sample of 65 mid-level managers working in the pharmacy health care sector, we found that RC among team members is positively related to a greater perceived overall fairness and high levels of dual allegiance. Additionally, teams with high levels of RC exhibit greater equity of individual member’s contribution as well as a more symmetric information distribution. Our findings also support that RC improves the performance outcomes set in place at the beginning of the overall process of collaborative knowledge creation, in terms of quality, cost (ability to meet budget objectives) and time (ability to meet major deadlines)."
Relational Coordination in Practice - Ideas from Denmark and Sweden
By Jody Hoffer Gittell
May 15, 2014
I’ve just finished a 10 day visit with our Danish and Swedish colleagues – a rich experience! In Denmark we’re seeing relatively advanced uses of relational coordination in highly practical ways. This is especially true in the municipalities where they are now responsible for healthcare in the community, behavioral health in the community, child care, K-12 education, after school activities, support for troubled families and children, employability support, immigrant integration, local culture and the physical infrastructure. It’s a challenging job and they take it quite seriously. As one municipal director said: “We are close to the citizens and we are very practical.”
These municipalities are seeing a need for better coordination and a growing number are using RC concepts, measures and interventions to connect across their silos and with their citizens. Last Tuesday, 750 people from Aarhus Kommune came to learn about relational coordination. This week, over 150 change leaders from many of the Danish municipalities participated in a national RC Conference called Relational Coordination in Practice to share their current work with each other. For some of their cool ideas - and more from Sweden - see here...
Reflections from Australia
By Jody Hoffer Gittell
April 14, 2014
Flying home from Australia over the weekend I found myself reflecting on what I learned. Australia has enjoyed a vibrant economy for more than two decades, boosted by an influx of human capital through immigration, a mining boom, and a robust import-export sector fueled by the rapid economic growth of their Asian neighbors, especially China. Several decades ago Australians also put into place a set of policies to fund public hospitals and higher education and have established a wage structure with one of the highest minimum wages in the world, existing hand in hand with relatively low and stable rates of unemployment.
Still, at The Future of Work conference this past week, leaders from the Australian private and public sectors were calling for more – for better leadership, more collaboration, more workforce engagement and greater utilization of the talents of Australia’s diverse workforce. Australia like other countries still struggles with sexism, racism and ageism in the workplace as well as inherited bureaucratic structures. As Rosemary Kirkby said, “The easiest way to be fast on your feet is to make sure everyone has a voice – and I don’t mean a focus group – I mean built into the process.”
This energetic, well-attended conference was hosted by the brand new national Centre for Workplace Leadership to advance its mission, which is simply “to create, source and share practical solutions that help you become a better leader and do things differently at work.” We welcome the Centre – led by Peter Gahan and Sarah Fortuna – as our newest RCRC Organizational Partner! Read more...
Fall Roundtable 2014 To Be Hosted By Billings Clinic September 4-5th - Montana Here We Come!
By Jody Hoffer Gittell
March 3, 2014
The RCRC Fall Roundtable 2014 will be hosted by our colleagues at Billings Clinic in Montana, including Curt Lindberg, Bob Merchant, Dania Block, Elizabeth Ciemens, Carlos Arce and their CEO Nick Wolter. We are thrilled to be convening at the Billings Clinic, where relational coordination is becoming an integral part of their approach to improving outcomes for patients and employees alike, starting in the Intensive Care Unit then extending to Orthopedics, Primary Care and beyond.
We will convene for learning and sharing on September 4 and 5, starting with outdoor activities during the day on September 4, with a welcoming reception that evening, then a full day of sharing on September 5, with closing reflections ending at 5:00 pm. The program will be posted here shortly, along with the opportunity to register and save your spot. We are limited to 100 registrants.
We chose early September to take full advantage of the natural beauty - from the Yellowstone River to the Bear Tooth Mountains to Yellowstone Park. Natural beauty aside, Billings Clinic is a leading health system using relational coordination for organizational change, along with complexity science and positive deviance. This Roundtable will be a chance to see first hand what they are doing, and to share the work you are doing. See here for updates.
Creating Coherence - Leadership and Coordination Across Boundaries
By Jody Hoffer Gittell
March 3, 2014
Last week Ninna Meier (Copenhagen Business School) and her colleagues from the Central Denmark Region presented their collaborative research and organizational development project, exploring the role of leadership and coordination in creating more coherent patient pathways across professional, organizational and geographical boundaries. At Brandeis University where Ninna is an RCRC Visiting Scholar, they presented baseline data on health system functioning in Denmark and invited us to help as they began to consider possible interventions.
Baseline data included deep qualitative observations in an Emergency Department, Oncology Ward, and Internal Medicine Unit, while the second phase will include relational coordination survey data - the strength of shared goals, shared knowledge, mutual respect, frequent, timely, accurate, problem-solving vs. blaming communication across roles, units and organizational boundaries - as additional input for intervention and change. One insight from the seminar was the need to better connect inpatient care with community-based care as the Danish municipalities strive to support health and wellness in the community.
Dr. Meier is a postdoctoral research fellow at Department of Organization, Copenhagen Business School, Denmark and a Visiting Scholar with the Relational Coordination Research Collaborative at Brandeis University this year. Ninna holds MS in Philosophy and Business Administration from the Department of Management, Politics and Philosophy, Copenhagen Business School, and a Ph.D. in Business Administration from Aarhus University focusing on Health Organization and Management.
Soft Side? Integrating Relational Coordination and Lean at Group Health
By Jody Hoffer Gittell
December 8, 2013
In early December, Signe Peterson Flieger and I journeyed out to Seattle to work with our colleagues at Group Health on integrating relational coordination and lean into a coherent methodology for organizational transformation. We were inspired by early pioneers like Earll Murman (MIT) and Walter Lowell (Maine Dept. of Health and Human Services) who refer to relational coordination as "the soft side of lean" and by colleagues like Dale Collins Vidal (Dartmouth-Hitchcock) and Margie Godfrey (Dartmouth Institute Microsystem Academy) who point out that relational coordination is actually quite hard in the sense of being both measurable and challenging to achieve.
Guided by Diane Rawlins (InsideOut Consulting and RCRC Partner) and Kim Demacedo (Group Health lean consultant), we spent 1.5 days building an integrated RC/lean approach with Group Health leaders Claire Trescott, Barbara Trehearne, Erika Fox, Michael Parchman, Rob Reid, Alicia Eng, Linda Boatman, Janice Wharton, Karen Severson and Thomas Nielsen. We discovered that RC and lean have some common underlying principles including systems thinking and attentiveness to relational dynamics such as problem solving rather than blaming communication and respect for people.
The immediate task was to combine relational coordination methods with lean methods as part of Group Health's evolution from Medical Home 1.0 to 2.0. We hope what we learn will have far-reaching implications for healthcare systems around the world, and will help us to further flesh out the Relational Model of Organizational Change
. We will be eager to share this integrated RC/lean methodology as it evolves - so stay posted and share your comments here!
Just Back from Denmark - Health and Wellness a Community Responsibility?
By Jody Hoffer Gittell
November 16, 2013
Flying home from Denmark I wanted to share some thoughts about health and wellness in the community. I visited several more municipalities, where much of the health and wellness work is now happening in Denmark. Max Kruse Director of Varde Municipality explained:
“With the healthcare revolution in Denmark we set up a clear separation of duties between regions and municipalities. We formed 5 regions for health and psychiatric care and 95 municipalities who are responsible for before citizens get sick and after they are out of hospital. Now municipalities pay 20% of the costs whenever our citizens go into the hospital or visit a doctor. Because of the 20% and because of our citizens, we have incentives to take care of our duties. Continue reading and join the conversation!
Reflections on the Fall Roundtable in Berkeley
By Jody Hoffer Gittell
October 22, 2013
We just spent a rewarding two days sharing our experiences with advancing the practice of relational coordination to achieve high performance. It was the third annual RCRC Roundtable, held at the University of California Berkeley. At the end one person observed, "I've never seen people at a conference listening so intently to each other!" The sense of connection was palpable - which was remarkable given that many were meeting for the first time. For the Roundtable booklet with its summary of activities and participants, see here.
Steve Shortell of UC Berkeley started us off by sharing recent data regarding the multiple levels - micro, meso and macro - at which relational coordination is needed to achieve the goals of accountable care. We realized through sharing that while people often see the need for it at their own level, they often see people at the other levels as obstacles to their work rather than as partners. Top management often sees the front line as failing to understand its need to build relational coordination at the macro system level while the front line sees top management as being unreceptive to the need to build and support relational coordination at the micro system level. Could the concepts of RC - shared goals, shared knowledge, mutual respect supporting frequent, timely, accurate, problem-solving communication - help us to connect conversations across these levels to build systems thinking?
We also explored:
- Unfreezing deeply entrenched professional roles and identities to build new ways of working together and how RC concepts can help to jump start the necessary conversations
- Including the patient, family and community on the team to co-produce desired outcomes including health and wellness - and new ways to assess and strengthen their inclusion
- Combining relational coordination with lean methods - this lively group figured out how to layer RC metrics onto work process maps to gain greater insight and avoid purely mechanistic approaches to lean
- Building RC metrics into our dashboards to gain ongoing visibility into the powerful dynamics of RC to inform our decisions and improvement efforts - this group also considered how the design of EHRs can foster or undermine the development of relational coordination across boundaries
- Identifying methods for developing leaders who are able to support relational coordination through systems thinking and humble inquiry
- Formation of an RC Learning Network with several leading health systems - a conversation that will continue in the aftermath of the Roundtable
Edgar Schein, MIT Sloan School, concluded the Roundtable with a reflection on the importance of doing interventions that are attentive to the needs of the participants, not allowing the ethic of "pure research" to override the ethic of helping. He also provided us with a deep dive into theories of organizational change, showing how these theories of change are needed to inform the practice of relational coordination.
I want to express deep gratitude to all the participants who made this Roundtable one of the best moments I have experienced in the journey we are on. And I send my gratitude to the host committee - Thomas Huber of Quantros, Kathy McDonald of Stanford, Terry Hill of Hill Physicians Group, Dominick Frosch of the Moore Foundation, Barbara Belk of Kaiser Permanente - whose energy and ideas and leadership made this possible. I also thank the RCRC team who worked and strategized since the spring to support the host committee - Debbie DeWolfe, Anna Perlmutter and Joanne Beswick. Their efforts were tireless and good spirited with much creative problem solving. A true example of relational coordination at work.
We are all grateful to UC Berkeley for hosting us on its lovely campus on a lovely Fall weekend - and to the Gordon and Betty Moore Foundation for its financial support.
I will conclude by reflecting back and thanking the visionaries who originally saw the potential for RC to become more than a research tool and more than an academic theory. They recognized RC as a way to foster behavior change and system change and they encouraged me to form the Relational Coordination Research Collaborative. They are Dale Collins Vidal from Dartmouth, Thomas Huber from Quantros, Ken Milne from Salus Global, Nancy Whitelaw from Salus Global, Stan Wallack from Brandeis, Kathy McDonald from Stanford, Gene Beyt from Brandeis, and Tony Suchman from McArdle Ramerman Center. They have been visionary leaders building a network that seems to grow each day.
And I especially want to thank the partners of the RCRC - our organizational partners, our research center partners, our professional partners, and our student and faculty partners. You are the RCRC and you have made it into a community. We look forward to the continued journey and we welcome others to participate! Please feel free to comment!
Ed Schein Speaks About His Newly-Released Book – Humble Inquiry
By William Brandel
September 3, 2013
Frank and thoughtful as always, Dr. Schein shares his motivations for writing a new book on the art of humble inquiry – and its essential role for supporting relational coordination and teaming – Humble Inquiry: On the Gentle Art of Asking Rather than Telling. This exclusive interview was conducted by Bill Brandel of Brandeis University and the Relational Coordination Research Collaborative. Continue reading and join the conversation!
Relational Coordination and Social Construction in Berlin – and Launching the RCRC Learning Center!
By Jody Hoffer Gittell
July 8, 2013
Just returned from The Summer Institute in Berlin co-hosted by the Taos Institute, a community of social construction practitioners, and Ramboll Attractor, a European management consulting firm. In its fifth year the Summer Institute brought together 250 people mostly from around Europe, especially Scandinavia, to explore social construction and systemic thinking in the transformation of people and organizations. There was much attention to connections between mind, body and spirit through conversation, singing and visual representations, as well as excellent workshops on relational leadership and more. Continue reading and join the conversation!
Relational Approaches to Safety
By Jody Hoffer Gittell
June 27, 2013
I just returned from Switzerland and a conference called “Safety Management in Context,” hosted by Gudela Grote (ETH Zurich) and John Carroll (MIT Sloan School of Management), about 75 people were invited from around the world to identify principles of safety management by comparing our experiences across countries and across industries. Continue reading and join the conversation!
Reflections on Relational Coordination Following the Colloquium
June 3, 2013
Conversations, connections, questions and insights – these were the outcomes of our very first Research Colloquium hosted last week at Brandeis University. Having set a limit of 55 participants, we exceeded that limit before early registration had even ended, and decided to accommodate 75 participants from all across the US — Northeast, Mid-Atlantic, Southeast, Midwest, Great Plains, Rocky Mountains, Southwest, West Coast and Northwest — as well as Australia, Belgium, Canada, Denmark, Netherlands, Ireland, Spain, Sweden and the UK. Continue reading and join the conversation!
Interview with Amy C. Edmondson, Author of “Teaming” by William Brandel, RCRC, Brandeis University
By William Brandel
February 13, 2013
Amy C. Edmondson is the Novartis Professor of Leadership and Management at Harvard Business School. Edmondson’s research examines leadership, learning and innovation in teams and organizations, and has been published in numerous academic and managerial articles. Organizations, Edmondson argues, thrive based on how well small groups – teams – within organizations work with each other. The pace and breadth of change in today’s world demands leaders who can create an environment where individuals can team, and teams can succeed. Edmondson spoke to RCRC about her book, and about what teaming means for relational coordination and healthcare. Continue reading and join the conversation!
Greetings from Palo Alto and News from the RCRC
By Jody Hoffer Gittell
April 28, 2013
Just arrived in Palo Alto last night, to speak at the Stanford Compassion and Business Conference on Tuesday. I’ll describe how relationships of shared goals, shared knowledge and mutual respect foster attentiveness to the situation and to one another – contributing to outcomes of quality, efficiency and well-being – and how organizational structures can be designed to support the scalability, replicability and sustainability of these relationships and outcomes. Other presenters are academic colleagues from U Penn, Stanford, Michigan and beyond, as well as business leaders who are working to put these principles into practice. I’m particularly thrilled to be joined by fellow members of the Center for Positive Organizational Scholarship including Sally Maitliss, Adam Grant, Kim Cameron and Monica Worline. Continue reading and join the conversation!
Reflections from the RCRC Community on Epic Systems and Other EHRs
By Jody Hoffer Gittell
March 20, 2013
I was in Madison last week to speak at the University of Wisconsin School of Business, hosted by friend and fellow MIT grad Chip Hunter who is now a dean there. Led by Chip’s colleague Mark Covaleski, we were invited to spend much of the day with Epic Systems — soon to be the largest EHR vendor in the US it would seem based on current trends — they serve several of RCRC’s partners and clients including Dartmouth, Kaiser, Group Health and most recently Partners Healthcare. Continue reading and join the conversation!
Understanding and Creating Caring and Compassionate Organizations
By Anna Perlmutter
January 28, 2013
In October 2012 Jody Hoffer Gittell and Anne Douglass’ article, “Relational Bureaucracy: Structuring Reciprocal Relationships into Roles,” was published in a special issue of the Academy of Management Review, dedicated to the subject of care and compassion in organizations. This month, the Academy of Management features a panel discussion among several editors and authors who contributed their unique perspectives and expertise to that October special issue. The forum, titled “Understanding and Creating Caring and Compassionate Organizations,” is devoted to the challenge of integrating care and compassion into the core values of organizational management. Continue reading and join the conversation!
Danish article from Lederweb “Coordinate Work Together – And Create Collaboration”
By Frida Louise Irhoj Damhus
January 3, 2013
Relations are important to daily work, whether related to management related contacts, internal group relations, or the relation to other departments, according to Frida Louise Irhøj Damhus of the Danish organization, Lederweb. Read her interview with professor and award-winning author Jody Hoffer Gittell during her visit to Copenhagen in September 2012. (translated from Danish by Thim Prætorius). Continue reading and join the conversation!