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Collaboration
Objectives• To describe the evolution of the concept of
collaboration
• To delineate the characteristics of collaboration
• To demonstrate the application of collaboration concept into practice
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Collaboration
Definition• Working together for a common goals• Pooling of resources and ideas within or across
disciplines for innovation and problem-solving (CINAHL)
• Interaction of 2 or more persons or organizations directed toward a common goal which is mutually beneficial (MEDLINE, cooperative behavior)
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Societal Shifts
• Nationalism replaced with global economy
• Social ecology--needs for integration & connections
• Social capital--networks, norms, trust, coordination & cooperation
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TRENDS
• New organizations• New forms of delivery
systems-- managed care
• New ways of relating to each other
• Smaller companies
• High-value organizations depend on and expect workers at all levels to be capable of making decisions
• Health care being driven by changes in industry
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Changing Work Environment
• Technology• Demographics• Managed Care• Purchaser’s Influence• Health Insurance
Industry• Changing Health
Systems• Telemedicine
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Managed Care Environment
• Focus on outcomes, research based practice
• High quality care
• Cost-effective interventions
• 2/3 with MH insurance are enrolled in managed care plans
• 4/5 of all states are implementing changes in Medicaid programs
• Responsible for widespread application of information technology
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Telecommunications
– Greater use will increase collaboration among health care professionals in physically separated locations
– Over 50% of US workforce employed in information related jobs
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Relationship to Health
• Concern not only with costs & benefits but with social, emotional, & physical health
• Promoting health and providing health care, no longer the exclusive domain of any discipline
• Need for interdependence to improve population health care outcomes
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Health Problems Needing Collaboration
• Mortality rates for persons with brain disorders are twice that of general population– 50% have known medical disorders– 35% have undiagnosed medical disorders– One in five has a medical problem may cause
or exacerbate psychiatric condition– Increased risk CVD
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Substance Abuse Problems Needing Collaboration
• 53% of drug abusers have at least 1 serious psychiatric problem
• 37% of alcohol abusers have at least 1 serious psychiatric problem
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Surrogate Terms
• Joint practice -> collaborative practice
• Shared governance – people discuss, debate, and work from the same data base; shared vision
• Coalition – take joint action or resolve a mutually shared concern or reach a common goal
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Related Concepts
• Cooperation – mutual give & take
• Collegial – equal power or authority
• Working together – intellectual endeavor
• Teamwork – team approach
• Interdependence, - shared power/authority
• Professionalism – antecedent
• Professional practice - consequence
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Implications
• Patient care – pts are the true beneficiaries
• Education – 1st step in the learning strategy
• Research – application of the findings
• Organization – shared governance -> better decisions regarding pt care
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Partnership Attributes
• Respecting each other
• Communication
• Working together
• Partnership relationship
• Trusting each other
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Conditions
• Supportive environment
• Mutual trust--acquired through experience among participants
• Disciplinary interests & personal agendas are secondary
• Process of negotiation
• Team building
• Transformational leadership
• Cannot mandate
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Characteristics
• Legitimacy /power sharing – Individual’s identity & accountability &
relationship to overall power• Self-knowledge
– Self-awareness & future growth• Respect
– Individual autonomy & boundary
• Commitment – Responsibility for goal attainment
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Outcomes
• Increased access
• Improved quality
• Positive client outcomes
• Increased creative solutions
• Improved and increased human resources
• A more productive community
• Greater student achievement
• Job satisfaction
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Outcomes (II)
• Education--meets service mission & gains practice settings for faculty & students
• Service--gains excitement of a learning environment
• Joint ventures– research and demonstration projects– develop models of practice
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Essential elements in organization’s readiness for collaboration
• Compatible R among Drs & Ns. – common goal & unique competencies
• Support from administration -> quality care
• Clinically competent of the staff
• Collegial R
• Primary nursing
• N’s excellence is rewarded
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assertiveness
cooperationlow
high
high
Competition
Avoidance
Collaboration
Accommodation
Compromise
2-dimensional grid of collaboration
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The driving forces of successful collaboration partnerships
• People -> enliven– Sharing of human resources– Careful planning & monitoring– Communication & understanding of goals &
purposes• Time
– Relationship– Skills
• Energy & motivation– Enthusiasm & commitment
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Transdisciplinary Collaboration ProjectSan Jose State UniversitySan Jose State University
Office of Sponsored ProgramsOffice of Sponsored ProgramsCollege of Applied Sciences and ArtsCollege of Applied Sciences and Arts
School of Nursing School of Nursing Nurse Managed CentersNurse Managed Centers
Communication Disorders & Sciences:Communication Disorders & Sciences: Program & ClinicProgram & Clinic
Department of Occupational TherapyDepartment of Occupational TherapyDepartment of Recreation & Leisure Studies: TRDepartment of Recreation & Leisure Studies: TR
College of Social WorkCollege of Social WorkInstitute for Teaching & LearningInstitute for Teaching & Learning
Faculty and StudentsFaculty and StudentsRevised 5/99Revised 5/99
Psychosocial.Psychosocial.Occupational Occupational Therapy ClinicTherapy Clinic
Santa ClaraSanta ClaraCountyCountyMentalMentalHealthHealth
Santa Clara CountySanta Clara CountyAlliance for theAlliance for the
Mentally IllMentally Ill
ALLIANCE for ALLIANCE for Community CareCommunity Care
Zoe HouseZoe HouseCrossroads VillageCrossroads Village
Casa FelizCasa Feliz
ResidentsResidentsStaffStaff
FamiliesFamilies
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Through collaborative efforts, provide quality, cost effective services for
persons with serious mental illness living in the community while simultaneously
preparing future mental health professionals for practice.
Project Goal
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Behavioral Ecological Model of Community Mental HealthLawsLaws
Administration ofAdministration ofJusticeJustice
CommunityCommunity
Friends and PeersFriends and Peers
LawsLaws
Mental Health Mental Health SystemSystem
Social PolicySocial Policy
LegislationLegislation
ChurchChurch
FamilyFamily
UniversityUniversity
Training ofTraining ofProfessionalsProfessionals
PersonPerson
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Stress Management• Nursing
– Crisis intervention• Deep Breathing
• Self Talk
• Time out
• Visualization
– Prevention• Diet & nutrition
• Exercise
• Time management
• Communication Disorders– Organizing and
creating schedules
– Follow up on comprehension
– Routines
– Social Skills
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Stress Management
• Therapeutic Recreation - Identify triggers - Identify & practice strategies to manage stress - Example: exercise, visualization, relaxation
• Occupational Therapy- Identify causes- Assess coping strategies- Environmental adaptations- Problem solving- Frustration tolerance- Therapeutic activity
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Outcomes of Collaboration Clearly, the closer educators, researchers,
consumers, practitioners, and families come together in the service area, the more likely that curricula will be reality based and congruent with clients’ needs. At the same time, the possibility of improving the quality of life increases.