Developing a culture of pride, confidence and trust: enhanced collaboration in an interdicisplinary team

Abstract

Background: Collaborative work is an inherently complex phenomenon. This article explores elements that enhance collaboration and argues that collaboration – understood as evolving processes whereby social entities actively and reciprocally engage in joint activities aimed at achieving a common goal – has not been given sufficient attention in the relevant Norwegian reforms. The Norwegian government implemented the Coordination Reform in January 2012, the aim of which was to provide a sustainable and high-quality health service (Ministry of Health and Care Services, 2012 ). This article uses the term ‘collaboration reform’ as this is the literal meaning of the Norwegian title Samhandlingsreform, and because collaboration seems to describe the aim of the reform better than coordination.

Aim: To explore how facilitated processes enhance collaboration in an interdisciplinary team, and discuss how the findings inform issues of collaboration between hospitals and municipal health services.

Methods: The design was a cooperative inquiry, that is, a participatory and shared approach to research that aims to facilitate understanding of a shared experience by virtue of cycles of action and reflection.

Findings/results: Taking part in facilitated processes gave the team members added awareness about their work, made them more able to handle complex situations and gave them confidence in their own competence and that of their and colleagues. The processes also gave team members opportunities for enhanced sharing and a broader agenda, to notice and detect, and to create a story about who we are and what we do.

Conclusions: Trusting and knowing each other is a foundation for collaborative work. The facilitated processes provided structure and direction, addressed power imbalances and kept the focus goal-centred. Cross-boundary collaboration between hospitals and municipal health services could improve with an awareness of collaboration as an evolving process involving reciprocity between social entities and participation in joint activities aiming at achieving a shared goal. Formal guidelines and agreements on a local basis could help promote joint responsibility for patients’ best interest.

Implications for practice:

Provision of integrated and coordinated services for patients can be improved by social entities engaging in joint activities

There is a need for facilitated networks across boundaries in the health services

Collaboration may improve with greater focus on the processes of sharing tasks and responsibilities

Knowledge about cooperating partners is crucial to optimise provision of integrated and coordinated services for patients