A Dissemination Strategy to Promote Relational Coordination in the Veterans Health Administration: A Case Study

Abstract

Background Implementing new healthcare practices across large organizations can be difficult due to inefficient diffusion of information. Using social marketing theory and additional evidence-based dissemination strategies, we spread relational coordination, an empirically supported theory of organizational performance, throughout the large Veterans Health Administration (VA). Relational Coordination drives performance outcomes including quality, efficiency, client satisfaction, and worker well-being and engagement and proposes interdependent work is most effectively coordinated by workers with each other, their customers, and their leaders. We aimed to develop a best-practice dissemination plan to educate and motivate researchers and operational staff in the VA to study and implement relational coordination within their programs of research or areas of operation.Methods In this observational case study, we followed the four Ps of social marketing theory to develop a strategy to disseminate relational coordination across the VA in two phases. In phase one, we created and distributed relational coordination information and invited VA staff to join the Relational Coordination Research Collaborative. In phase two dissemination efforts targeted researchers who were ready to study and implement relational coordination within existing programs of research. Primarily observational data were collected through both stages of the project and a final, post-project survey was administered after the second phase. The quantitative results were calculated using descriptive statistics and text responses in the survey were analyzed using deductive content analysis. A structured categorization matrix was developed to code the responses based on the survey questions. Results The first phase saw instances of social media dissemination, presentations, as well as phone or email communication between project staff and the target audience. 47 members of VA staff joined the Relational Coordination Research Collaborative and 50% participated in online research seminars. 13 research projects applied for the second stage and 5 projects were ultimately chosen to access the Relational Coordination survey. Relational coordination-related trainings, presentations, and publications also occurred.Conclusions Dissemination approaches that involved personalized, one-on-one efforts seemed to be more effective at spreading relational coordination compared to social media or other online presentations. Participants in the second phase overwhelmingly agreed to that relational coordination should be adopted in the VA but indicated the cost of the program would have been a barrier. Results reiterate the importance of an intentional dissemination plan, including addressing the costs and benefits of programs