South Florida Hospital News
Tuesday January 19, 2021

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August 2012 - Volume 9 - Issue 2


Healthcare Managers need to be Collaborative Leaders to Meet Tomorrow's Challenges

After the publication of Rosabeth Moss Kanter’s 1994 article on the advantages of collaboration, the term collaborative leadership was coined to describe the leadership skills and attributes needed to successfully develop and manage inter-organizational strategic alliances and other forms of partnership. The collaborative leader’s basic task is to achieve positive outcomes for common objectives among different organizations. For example, a collaborative manager of a county’s department of disaster/emergency management must effectively lead and coordinate the emergency responses of multiple organizations, government agencies, and community resources before, during, and after an emergency or disaster. Given the different cultures and goals among organizations, promoting effective collaboration can be a challenging task!
As healthcare reform moves the industry from segment-based delivery models to integrated systems such as accountable care organizations (ACOs), collaborative leadership becomes critical to organizational success. The leader of an ACO is expected to integrate and coordinate the various component parts of healthcare, such as primary care, specialty services, hospitals, and home health care; and to ensure that all "parts function well together" to deliver efficient, high quality, and cost-effective patient-centered care. Managers of 21st century healthcare organizations must be able to lead diverse groups of people and facilitate their professional efforts and problem-solving both within an organization as well as across formal organizational boundaries.
Traditionally, leadership is described as one’s ability to move an organization toward its strategic goals by influencing other organizational members to participate in a collaborative effort to achieve corporate success and economic sustainability. However, collaborative leadership is more complex because it requires a leader to achieve success by motivating individuals in multiple organizations, in addition to bringing together and aligning the goals of many stakeholders. However, in many circumstances, these stakeholders may be engaged in adversarial relationships because they hold different perspectives of their mission, vision, objectives, and concerns. As such, leaders need to overcome common challenges when facilitating collaborative endeavors. These challenges include disagreement among stakeholders regarding the definition of the problem, varying interests, resources and knowledge bases, and past history of unsuccessful collaborative attempts.
In today’s complex and competitive healthcare environment, collaborative relationships allow organizations to achieve better outcomes by obtaining knowledge, skills, technology, or other essential resources that a single organization cannot provide on its own. Collaborative partnerships bring together individuals with very different knowledge bases, attitudes, and assumptions. Each partner possesses unique knowledge and skills that can benefit the others. As partners organize, plan strategies, and move forward, they create learning opportunities for themselves and each other.
The newly-established New York Genome Center (NYGC) is an example of how under highly effective collaborative leadership, an ecosystem from previously fragmented and competitive healthcare sectors can be formed with the goals of improved patient outcomes and the delivery of personalized medicine. NYGC, a public-private coalition of competitors - universities, medical centers, technology firms, and pharmaceutical companies, have joined together in a cooperative effort to transform medical research and clinical care. Under NYGC’s efforts, stakeholders, such as healthcare managers, scientists, clinicians, policymakers, payers, and patients, are engaged in information-enabled common projects for therapeutic and diagnostic product development.
In today’s complex healthcare environment, collaborative alliances are emerging as the preferred model for complex problem-solving or “getting the job done” especially when diverse stakeholders address issues that affect broad segments of an organization or community. To promote collaborative problem-solving among stakeholders, the healthcare manager should demonstrate the following specific behaviors:
1. Confidence that the goals and objectives are achievable.
2. The skills to clearly communicate with the stakeholders regarding the issues needing to be addressed and the potential approaches to problem solving.
3. The ability to serve as an active listener.
4. The ability to share knowledge and authority with the collaborators
5. The ability to assess and handle varying levels of risk in decision-making and implementation.
Although, collaborative leadership has much in common with both transformational and servant leadership theories, there are also many differences. One of the main differences is that collaborative leader must be able to achieve success through alliances with people and resources beyond their direct reporting control. By definition, collaborative leaders have no formal authority over their peers. They must use persuasion, technical competence, relationship skills, and political smarts to get and keep the coalition together and produce the desired goal. Despite the many advantages of collaborative leadership, disadvantages also exist. Some of the disadvantages are:
(1) Collaboration may be a slow and time-consuming process,
(2) There may be a high degree of conflict requiring management and mediation, and
(3) Collaborative leaders may need to concede some of their power and authority to the partnership, and credit the group rather than themselves for the positive outcomes achieved.
Though collaboration can be challenging, the advantages of collaborative management within an organization and across entities can outweigh the potential difficulties. The movement towards ACOs will require that leaders add managing collaboration to their skill set for the benefit of their organizations, patients, and communities. As such, tomorrow’s healthcare collaborative leaders will need to demonstrate a vision-based, system-thinking, power-sharing leadership style. 

Nancy Borkowski, Clinical Associate Professor, Executive Director, Health Management Programs, Chapman Graduate School of Business, Florida International, can be reached at (305) 779-7901 or Barbara Perez Deppman, President, itMD, and Adjunct Faculty, FIU, can be reached at (888) 778-2552.

Excerpt from Borkowski, N. & Deppman, B. Collaborative Leadership in Rubino, L. & Esparza, S. (Eds), New Leadership for Today's Healthcare Professionals: Concepts and Cases, Jones & Barlett Publishers (forthcoming).


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