This case represents the collaborative type in an early stage of development. The effort centered heavily on the strong leadership of a doctor cardiologist who emphasized a strong focus on patient care, the primary professional value shared across a wide range of levels and functions. Like Hightown, this unit relied on a set team of highly skilled practitioners working for the lead physician cardiologist who helped spread and reinforce the message; unlike Hightown, these key agents in this case were Fellows (physicians in undergoing specialized training in cardiology) rather than Advanced Practice Nurses. There were two interesting and potentially fruitful aspects of the United effort. The first ran directly counter to our expectations: although the role of the lead physician was (as predicted) very strong, he did not play the role of guardian and protector against other parts of the hospital, as did his counterpart at Hightown. Rather than trying to seal off his unit as a special domain, he engaged in intensive networking with other areas and tried to draw them into his vision of cardiac care. There was some evidence that this approach was having good effects. Relations to other units were relatively cooperative, and there was a smoother relationship with the nursing hierarchy than at our other sites. Second, this initiative focused at the start on standardization of a very clear set of procedures – the processes rather than on a broader vision of relations. But this was driven by the “8-scope” – doctor, rather than administrators, and engaged a wide variety of actors at all levels in the pursuit of this objective. There were strong interdisciplinary elements, including two formal committees
This case represents the collaborative type in an early stage of development. The effort centered heavily on the strong leadership of a doctor cardiologist who emphasized a strong focus on patient care, the primary professional value shared across a wide range of levels and functions. Like Hightown, this unit relied on a set team of highly skilled practitioners working for the lead physician cardiologist who helped spread and reinforce the message; unlike Hightown, these key agents in this case were Fellows (physicians in undergoing specialized training in cardiology) rather than Advanced Practice Nurses. There were two interesting and potentially fruitful aspects of the United effort. The first ran directly counter to our expectations: although the role of the lead physician was (as predicted) very strong, he did not play the role of guardian and protector against other parts of the hospital, as did his counterpart at Hightown. Rather than trying to seal off his unit as a special domain, he engaged in intensive networking with other areas and tried to draw them into his vision of cardiac care. There was some evidence that this approach was having good effects. Relations to other units were relatively cooperative, and there was a smoother relationship with the nursing hierarchy than at our other sites. Second, this initiative focused at the start on standardization of a very clear set of procedures – the “8-scope” processes – rather than on a broader vision of relations. But this was driven by the doctor, rather than administrators, and engaged a wide variety of actors at all levels in the pursuit of this objective. There were strong interdisciplinary elements, including two formal committees
%60Collaboration%20and%20the%20Quality%20of%20Health%20Care.docx