Quality Improvement: Supporting a hospital in difficulty: ­experience of a ‘­buddying’ agreement to implement a new medical pathway

Leach, Richard H.; Banerjee, Sandip; Beer, G. De; Tencheva, Svetka; Conn, Deidre; Waterman, Ashley; Parrott, Jackie; Gifford, Julie; Steddon, Simon; Abbs, I C; Pritchard, Amanda Barone; Kerr, Ron; Dwyer, Lesley; Hamilton‐Fairley, Diana

doi:10.7861/futurehosp.6-1-67

Cited by 9 publications

(7 citation statements)

References 9 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Involvement of stakeholders (context) ➔ increased authenticity of the collaboration (mechanism) ➔ increased faith in the collaboration (outcome) Leadership Eight of the included studies mentioned leadership as being key to the success of partnerships; however, few elucidated upon why [13,34,36,47,49,56,58,61]. Evans and Killoran [56], in their realistic evaluation of five different models of partnership working, mention 'leadership and management skills' being enhanced through 'external consultancy support' and 'strong project leadership', but do not outline the mechanisms underlying these aspects.…”

Section: If There Are Conflicting Cultures Between Partners (Context) ➔ Then Increased Interpersonal Communication (Mechanism) ➔ May Leadmentioning

confidence: 99%

“…Evans and Killoran [56], in their realistic evaluation of five different models of partnership working, mention 'leadership and management skills' being enhanced through 'external consultancy support' and 'strong project leadership', but do not outline the mechanisms underlying these aspects. Wildridge et al [13] mention 'continuing, visible, and joint commitment from individuals in positions of leadership and influence' as very important, and Leach et al [34] mention in their evaluation of a buddying programme that 'compassionate leadership' was key. Leadership is essential to any kind of organisation, regardless of whether they are collaborating with another, but is not in all cases a mechanism that underlies partnership, rather, can perhaps also be a context that frames the partnership from the outset.…”

Section: If There Are Conflicting Cultures Between Partners (Context) ➔ Then Increased Interpersonal Communication (Mechanism) ➔ May Leadmentioning

confidence: 99%

See 1 more Smart Citation

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

et al. 2021

View full text Add to dashboard Cite

Background Inter-organisational collaboration is increasingly prominent within contemporary healthcare systems. A range of collaboration types such as alliances, networks, and mergers have been proposed as a means to turnaround organisations, by reducing duplication of effort, enabling resource sharing, and promoting innovations. However, in practice, due to the complexity of the process, such efforts are often rife with difficulty. Notable contributions have sought to make sense of this area; however, further understanding is needed in order to gain a better understanding of why some inter-organisational collaborations work when others do not, to be able to more effectively implement collaborations in the future. Methods Realist review methodology was used with the intention of formulating context-mechanism-outcome configurations (CMOCs) to explain how inter-organisational collaborations work and why, combining systematic and purposive literature search techniques. The systematic review encompassed searches for reviews, commentaries, opinion pieces, and case studies on HMIC, MEDLINE, PsycINFO, and Social Policy and Practice databases, and further searches were conducted using Google Scholar. Data were extracted from included studies according to relevance to the realist review. Results Fifty-three papers were included, informing the development of programme theories of how, why, and when inter-organisational collaborations in healthcare work. Formulation of our programme theories incorporated the concepts of partnership synergy and collaborative inertia and found that it was essential to consider mechanisms underlying partnership functioning, such as building trust and faith in the collaboration to maximise synergy and thus collaborative performance. More integrative or mandated collaboration may lean more heavily on contract to drive collaborative behaviour. Conclusion As the first realist review of inter-organisational collaborations in healthcare as an intervention for improvement, this review provides actionable evidence for policymakers and implementers, enhancing understanding of mechanisms underlying the functioning and performing of inter-organisational collaborations, as well as how to configure the context to aid success. Next steps in this research will test the results against further case studies and primary data to produce a further refined theory. Systematic review registration PROSPERO CRD42019149009

show abstract

Section: If There Are Conflicting Cultures Between Partners (Context) ➔ Then Increased Interpersonal Communication (Mechanism) ➔ May Leadmentioning

confidence: 99%

Section: If There Are Conflicting Cultures Between Partners (Context) ➔ Then Increased Interpersonal Communication (Mechanism) ➔ May Leadmentioning

confidence: 99%

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Eight of the included studies mentioned leadership as being key to the success of partnerships, however, few elucidated upon why (13,34,36,47,49,56,58,61). Evans and Killoran (2000), in their realistic evaluation of ve different models of partnership working, mention "leadership and management skills" being enhanced through "external consultancy support" and "strong project leadership" but do not outline the mechanisms underlying these aspects.…”

Section: Leadershipmentioning

confidence: 99%

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Aunger

Millar

Greenhalgh

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Inter-organisational collaboration is increasingly prominent within contemporary healthcare systems. A range of collaboration types such as alliances, networks, and mergers have been proposed as a means to turnaround organisations, by reducing duplication of effort, enabling resource sharing, and promoting innovations. However, in practice, due to the complexity of the process, such efforts are often rife with difficulty. Notable contributions have sought to make sense of this area, however further understanding is needed in order to gain a better understanding of why some inter-organisational collaborations work when others do not, to be able to more effectively implement collaborations in the future. Methods Realist review methodology was used with the intention of formulating context-mechanism-outcome configurations (CMOCs) to explain how inter-organisational collaborations work and why., combining systematic and purposive literature search techniques . The systematic review encompassed searches for reviews, commentaries, opinion pieces and case studies on HMIC, Medline, PsycINFO, and Social Policy and Practice databases and further searches were conducted using Google Scholar. Data were extracted from included studies according to relevance to the realist review. Results Fifty-three papers were included, informing the development of programme theories of how, why, and when inter-organisational collaborations in healthcare work. Formulation of our programme theories incorporated the concepts of Partnership Synergy and Collaborative Inertia and found that it was essential to consider mechanisms underlying partnership functioning, such as building trust and faith in the collaboration to maximise synergy and thus collaborative performance. More integrative or mandated collaboration may lean more heavily on contract to drive collaborative behaviour. Conclusion As the first realist review of inter-organisational collaborations in healthcare as an intervention for improvement, this review provides actionable evidence for policymakers and implementers, enhancing understanding of mechanisms underlying the functioning and performing of inter-organisational collaborations, as well as how to configure the context to aid success. Next steps in this research will test the results against further case studies and primary data to produce a further refined theory. Review registration This review is registered at PROSPERO with ID CRD42019149009. Keywords Collaboration, partnership working, integration, healthcare, improvement, realist review, realist synthesis, context, programme theory, implementation

show abstract

“…Additionally, having a larger size and/or number of organisations involved can make communicating more di cult due to the increased number of involved actors and moving parts (50). IT system compatibility (45,75), joint appointments (66), and having regular collaboration-wide meetings can also work to increase trust as an outcome through the mechanism of interpersonal communication (44,60). When cultures are mismatched or not mutually understood, con ict can occur, which thereby reduces trust (71).…”

Section: Middle Stage Of Collaborationmentioning

confidence: 99%

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Aunger

Millar

Greenhalgh

2021

Preprint

View full text Add to dashboard Cite

Background Health systems are facing unprecedented socioeconomic pressures as well as responding to the ongoing strains and surges brought about by the Covid-19 pandemic. In response, the reconfiguration of health systems to encourage greater collaboration and integration has been promoted with a variety of collaborative shapes and forms being encouraged and developed. Despite this continued interest, evidence for success of these various arrangements is lacking with the links between collaboration and improved performance often remaining uncertain. To date, many examinations of collaborations have been undertaken, but use of realist methodology may shed additional light on how and why collaboration works, and whom it benefits. Methods This paper seeks to test initial context-mechanism-outcome configurations (CMOCs) of interorganisational collaboration with the view to producing a refined realist theory. This phase of the review used case study and evaluation literature; combined with supplementary systematic searches. These searches were screened for rigour and relevance, after which CMOCs were extracted from included literature and compared against existing ones for refinement, refutation, or affirmation. We also identified demi-regularities to better explain how these CMOCs were interlinked.Results Fifty-one papers were included, from which 338 CMOCs were identified, where many were nonunique. This resulted in new mechanisms such as ‘risk threshold’ and refinement of many others, including trust, confidence, and faith, into more well-defined constructs. Refinement and addition of CMOCs enabled the creation of a ‘web of causality’ depicting how contextual factors form CMOC chains which generate outputs of collaborative behaviour. Core characteristics of collaborations, such as whether they were mandated or cross-sector, were explored for their proposed impact according to the theory.Conclusion The formulation of this refined realist theory allows for greater understanding of how and why collaborations work and can serve to inform both future work in this area and the implementation of these arrangements. Future work should delve deeper into collaborative subtypes and the underlying drivers of collaborative performance.Review registration This review is part of a larger realist synthesis, registered at PROSPERO with ID CRD42019149009.

show abstract

Quality Improvement: Supporting a hospital in difficulty: experience of a ‘buddying’ agreement to implement a new medical pathway

Abstract: targeting of specific issues; ability to influence people and foster relationships; adequate 'manpower' and gradual transition to local 'ownership'.

Cited by 9 publications

References 9 publications

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Contact Info

Product

Resources

About

Quality Improvement: Supporting a hospital in difficulty: ­experience of a ‘­buddying’ agreement to implement a new medical pathway

Abstract: targeting of specific issues; ability to influence people and foster relationships; adequate 'manpower' and gradual transition to local 'ownership'.

Cited by 9 publications

References 9 publications

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Contact Info

Product

Resources

About

Quality Improvement: Supporting a hospital in difficulty: experience of a ‘buddying’ agreement to implement a new medical pathway