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Applying Organizational Science to Health Care: A Framework for Collaborative Practice

Dow, Alan W. MD, MSHA; DiazGranados, Deborah PhD; Mazmanian, Paul E. PhD; Retchin, Sheldon M. MD, MSPH

doi: 10.1097/ACM.0b013e31829523d1
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Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.

In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader’s integration into a team’s usual work) and formality (a leader’s responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes.

Dr. Dow is assistant vice president of health sciences for interprofessional education and collaborative care, assistant dean of medical education, and associate professor of medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.

Dr. DiazGranados is assistant professor, Office of Assessment and Evaluation Studies, School of Medicine, and program evaluator, VCU Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia.

Dr. Mazmanian is associate dean for assessment and evaluation studies, School of Medicine, and director of evaluation, VCU Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia.

Dr. Retchin is senior vice president of health sciences, Virginia Commonwealth University, and chief executive officer, VCU Health System, Richmond, Virginia.

Correspondence should be addressed to Dr. Dow, Virginia Commonwealth University, School of Medicine, Box 980565, Richmond, VA 23298-0565; telephone: (804) 828-9790; fax: (804) 828-0086; e-mail: adow@mcvh-vcu.edu.

© 2013 by the Association of American Medical Colleges