Leadership in Volunteer Multistakeholder Groups Tackling Complex Problems

Hilton, Kate B.; Wageman, Ruth

doi:10.1108/s1479-357120160000008016

Cited by 6 publications

(3 citation statements)

References 44 publications

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“…Most musicians will acknowledge that the quality of a performance is dependent on the audience, and most health care personnel would agree that the chances for a positive outcome are strongly influenced by the patient and their community. While a discussion of the details of including patient voices in health care team decision making is beyond the scope of this article, we would just observe that modern articulations of patientcentered care, [41,42] community engagement [43], co-production of care [44], as well as the processes of communitybased participatory health research [45], align well with the realization of the paradoxes of power and role-transcendence that Bill Evans, Scott Lafaro, and Paul Motian grappled with nearly sixty years ago.…”

Section: Discussionmentioning

confidence: 99%

Towards an evolution of interprofessional practice: Lessons learned from two jazz piano trios

Haidet

Madigosky²

2020

Patient Education and Counseling

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Interprofessional practice has been of great interest to both health systems and educational institutions, but has been slow to develop in actual practice. Important efforts to speed adoption have mostly focused on changes in structure or educational interventions. It turns out that the field of jazz music was grappling with similar issues in the early 1960s. In this essay, we draw lessons from the experiences of jazz musicians during a time of transition. We conclude that significant cultural transformation, focused on two paradoxes, and the barriers and contexts that flow from them, will be necessary to achieve ideal interprofessional healthcare practice.

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Section: Discussionmentioning

confidence: 99%

Towards an evolution of interprofessional practice: Lessons learned from two jazz piano trios

Haidet

Madigosky²

2020

Patient Education and Counseling

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“…The method enables an analyst to systematically identify social ties among all pairs of actors within a network to reveal patterns of social structure, using computer analysis so large amounts of matrix data can be analysed quickly (Breiger, 2004;Breiger & Ennis, 1979;Wang et al, 2016). In the context of healthcare partnerships, Hilton and Wageman (2016) use social network analysis to understand how a public health multistakeholder project built up networks over time, revealing changing positions of leaders and healthcare actors to build identity and connection as well as to bridge positions among those who had not previously worked together. However, social network analysis does not reveal much about the motivations for trust within these networks nor how to create, sustain or grow trust.…”

Section: Prevailing Methods For Trust Research In Health Systemsmentioning

confidence: 99%

Trust is the engine of change: A conceptual model for trust building in health systems

Adam

Donelson²

2020

Syst Res Behav Sci

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We examine trust at the theory level as an engine driving sustainable change.We propose a new measurable dimension of the trust construct: reciprocity. Cooperative reciprocal relationships are its building blocks, enabling stakeholders to 'try out' interactions with less risk, calibrating level of effort, time and emotional investment before continuing further. Reciprocity includes three measurable elements: common goals furthering equitable and healthier communities, mutual self-interests and gratitude/indebtedness. We utilize a process model showing how these building blocks interrelate within a health systems context to jump-start and sustain reciprocal relationships. Process models are valuable in addressing internal dynamics of human relationships in complex systems as a complement to factor-or variance-based models. We applied theory by longitudinally tracking community health volunteers, examining reciprocity in close-to-the-community health systems. These methods and application of theory have relevance to environments where institutional structures are open to multistakeholder-driven innovation.

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“…The method enables an analyst to systematically identify social ties among all pairs of actors within a network to reveal patterns of social structure, using computer analysis so large amounts of matrix data can be analyzed quickly (35)(36)(37). In the context of health care partnerships, Hilton (38) uses social network analysis to understand how a public health multi-stakeholder project built up networks over time, revealing changing positions of leaders and health care actors to build identity and connection as well as to bridge positions among those who had not previously worked together.…”

Section: Objectivesmentioning

confidence: 99%

Trust is the engine of change: A conceptual model for trust building in health systems

Adam

Donelson²

2020

Preprint

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Background: Physicians, health care organizations, governments and communities are increasingly interested in how trust is built throughout the health system. Current science on building trust draws on diverse literature from business and consumer science to healthcare, and theory development has predominately focused on factor based models. We propose a process based theoretical model for trust building which may better reflect the complex and dynamic nature of trust itself. In doing so, we propose a new measurable dimension of the trust building process: reciprocity cycles. Cooperative reciprocal relationships are its building blocks, enabling stakeholders to “try out” their interactions with less risk, and to calibrate their level of effort, time and emotional investment. Reciprocity cycles includes three measurable elements: common goals, self-interests and gratitude/indebtedness.Methods: We applied the model, developing outcomes and measures in close-to-community health partnerships in Kenya. A 3-day workshop designed to stimulate problem solving and collaborative teamwork using human centered design principles was offered in 2 community health units in diverse contexts (rural agrarian and peri-urban flower farm slum), each with about 30 community health volunteers (CHVs) serving a population of approximately 5,000. Each unit formed separate teams representing specific villages; we followed these 9 teams between 18 to 24 months.Results: All 9 volunteer CHV teams delivered on self-directed public health outcomes across the spectrum of social determinants of health over the follow up period, with no funding, only using their own locally available resources. Projects were diverse, including immunization, composting toilets, hygiene, neonatal and reproductive health and public gardening. All 9 teams demonstrated trust building reciprocity cycles with articulation of common goal, self-interest, and gratitude/indebtedness. Conclusion: A process model of trust building, defined by reciprocity cycles, can be stimulated with a short intervention (illustrated here in close-to-community health systems) resulting in trusting relationships that drive agency and co-production of positive outcomes for health systems. In addition, it offers a simpler, more useful framework for trust building and measurement than traditional models of trust in health systems research. Early findings illustrate reciprocity cycles are scalable and adaptable, with potential utility at multiple levels of health systems.

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Leadership in Volunteer Multistakeholder Groups Tackling Complex Problems

Cited by 6 publications

References 44 publications

Towards an evolution of interprofessional practice: Lessons learned from two jazz piano trios

Towards an evolution of interprofessional practice: Lessons learned from two jazz piano trios

Trust is the engine of change: A conceptual model for trust building in health systems

Trust is the engine of change: A conceptual model for trust building in health systems

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