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 1

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) 2

Societal Shifts

• Nationalism replaced with global economy • Social ecology--needs for integration & connections • Social capital- networks, norms, trust, coordination & cooperation 3

TRENDS

• 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 • New organizations • New forms of delivery systems-- managed care • New ways of relating to each other • Smaller companies 4

Changing Work Environment

• Technology • Demographics • Managed Care • Purchaser’s Influence • Health Insurance Industry • Changing Health Systems • Telemedicine 5

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 6 information technology

Telecommunications

– Greater use will increase collaboration among health care professionals in physically separated locations – Over 50% of US workforce employed in information related jobs 7

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 8

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 9

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 10

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 11

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 12

Implications

• Patient care – pts are the true beneficiaries • Education – 1 st step in the learning strategy • Research – application of the findings • Organization – shared governance -> better decisions regarding pt care 13

Partnership Attributes

• Respecting each other • Communication • Working together • Partnership relationship • Trusting each other 14

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 15

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 16

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 17

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 18

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 19

high Competition Collaboration Compromise Avoidance Accommodation low cooperation 2-dimensional grid of collaboration high 20

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 21

Transdisciplinary Collaboration Project Psychosocial.

Occupational Therapy Clinic

San Jose State University

Office of Sponsored Programs College of Applied Sciences and Arts School of Nursing Nurse Managed Centers Communication Disorders & Sciences: Program & Clinic Department of Occupational Therapy Department of Recreation & Leisure Studies: TR College of Social Work Institute for Teaching & Learning Faculty and Students Revised 5/99 Santa Clara County Mental Health Santa Clara County Alliance for the Mentally Ill Residents Staff Families ALLIANCE for Community Care Zoe House Crossroads Village Casa Feliz 22

Project Goal

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.

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Behavioral Ecological Model of

Administration of Justice Community Friends and Peers Laws Mental Health System Person Training of Professionals Church Family Social Policy Legislation 24

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 25

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 26

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.

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