Program on Collaborative Health Care Delivery

The Center for the Study of Collaboration in Health Care conducts research on efforts to bring together key stakeholders -- doctors, nurses, administrators, regulators, and others -- in collaborative efforts for health care improvement. It also designs interventions based on this research.

There is considerable evidence from other researchers and practitioners supporting this basic relation between effective interdisciplinary collaboration and health outcomes. There are situations when a directive intervention to standardize processes may have good results for a time. But we hypothesize that sustained high performance, especially for the treatment of  complex chronic conditions, will require close interdisciplinary collaboration which involves quite fundamental changes in practices throughout the health care system.

Our initial research examined four cardiac care units in New Jersey hospitals. The best performers -- among the best in the state on both process and outcome measures -- were pursuing a deliberately collaborative approach, bringing together nurses, doctors, and other care providers to develop treatment plans By contrast, the two other units, among the worst in the state, were ones in which administrators were trying to impose performance standards on reluctant physicians. A paper based on that research has been submitted for publication.

We have recently completed survey research at Massachusetts General Hospital in Boston testing the relation between interprofessional collaboration and outcomes of patient care and cost efficiency. We will to soon extend this survey to other hospitals in the US, the UK, and China.

Publications

• Collaboration and the Quality of Health Care
• Mutations of Professional Responsibility