Timely Communication Through Telehealth: Added Value for a Caregiver During COVID-19

Objective: This caregiver case study applies the lens of relational coordination theory (RC) to examine the value of telehealth as a medium of care coordination for a pediatric patient with hypermobile Ehlers-Danlos Syndrome (hEDS) during the COVID-19 pandemic.Background: The COVID-19 pandemic has placed an unprecedented burden on the delivery of healthcare around the globe and has increased the reliance on telehealth services. Delivering telehealth requires a high level of communication and coordination within and across providers as well as between providers, patients and their families. However, it is less clear how telehealth impacts the coordination of care. In this paper, we provide insight into the quality of care coordination between providers and an informal caregiver following policy changes to the provider payment structure in Massachusetts.Methods: This paper employs a single-case, autoethnographic study design where one of the authors uses their experiential insights, as mother of the patient, to inform a wider cultural and political understanding of the shift to remote caregiving for a pediatric patient with hEDS. Data was collected using reflective journaling, interactive interviews, and participant observation and analyzed using content analysis.Results: Findings revealed four interrelating roles of the caregiver including, logistics support, boundary spanner, home health aide, and cultural translator. The adoption of telehealth was associated with improved timeliness and frequency of communication between the caregiver and providers. Findings about the impact of telehealth adoption on accuracy of communication were mixed. Mutual respect between the caregiver and providers remained unchanged during the study period.Conclusions: This paper highlights areas where payer policy may be modified to incentivize timely communication and improve coordination of care through telehealth services. Additional insight from the perspective of an informal caregiver of a patient with a rare chronic disease provides an understudied vantage to the care coordination process. We contribute to relational coordination theory by observing the ways that caregivers function as boundary spanners, and how this process was facilitated by the adoption of telehealth. Insights from this research will inform the development of telehealth workflows to engage caregivers in a way that adds value and strengthens relational coordination in the management of chronic disease.

Using Objectives and Key Results (OKRs) and Slack: A Case Study of Coordination in Large-Scale Distributed Agile

Today, many large-scale software projects have members working from home, which has changed the way teams coordinate work. To better understand coordination in this setting, we conducted a case study through which we examined two teams in a large-scale agile project by observing meetings and conducting 17 interviews. Through the lens of Relational Coordination Theory (RCT), we analyzed the use of the goal-setting framework Objectives and Key Results (OKRs) and the collaboration tool Slack. Slack was used for frequent, timely, and problem-solving communication and, and its use decreased the number of planned meetings. However, discussions often started on Slack and continued in virtual ad-hoc meetings. The use of OKRs facilitated knowledge sharing, helped the teams align their goals, and provided inter-team insights. The main implication of our research is that projects using OKRs need to support project members, especially in formulating the key results that align and motivate the teams to work toward the same mission.

Using Objectives and Key Results (OKRs) and Slack: A Case Study of Coordination in Large-Scale Distributed Agile

Today, many large-scale software projects have members working from home, which has changed the way teams coordinate work. To better understand coordination in this setting, we conducted a case study through which we examined two teams in a large-scale agile project by observing meetings and conducting 17 interviews. Through the lens of Relational Coordination Theory (RCT), we analyzed the use of the goal-setting framework Objectives and Key Results (OKRs) and the collaboration tool Slack. Slack was used for frequent, timely, and problem-solving communication and, and its use decreased the number of planned meetings. However, discussions often started on Slack and continued in virtual ad-hoc meetings. The use of OKRs facilitated knowledge sharing, helped the teams align their goals, and provided inter-team insights. The main implication of our research is that projects using OKRs need to support project members, especially in formulating the key results that align and motivate the teams to work toward the same mission.

The significance of interprofessional and interagency collaboration in reintegration after prison

The Norwegian Correctional Service is well known for its focus on rehabilitation and the humane treatment of offenders. However, welfare issues and comorbidity are overrepresented among offenders, and recidivism rates remain unacceptably high. Mental health problems, substance abuse and a lack of housing suggest that offenders need support from a range of services in their reintegration processes. This calls for collaboration between frontline workers, welfare agencies and non-governmental organizations, especially in the transition from prison back into society. In the present study, we aim to explore frontline workers’ views of interprofessional and interagency collaboration among frontline workers working with offenders suffering from substance abuse issues in their reintegration after prison. Semi-structured interviews were conducted with nine frontline workers employed in welfare agencies and the correctional service, with workers directly engaged in supporting offenders´ reintegration after prison. Findings suggest that interprofessional collaboration is perceived as multifaceted. The participants in the study perceived the welfare needs of offenders as complex, and the transition phase from prison as particularly vulnerable. Finally, findings suggest that frontline workers’ individual values and engagement in the work, as well as a lack of shared knowledge and shared information among frontline workers, are perceived as important factors in how collaboration processes unfold. We further argue that there is a need for additional knowledge, such as theoretical frameworks and conceptual models, to increase the understanding of interprofessional collaboration in the interface between prison and welfare services. We discuss substance abusers’ transition from prison into society and interprofessional collaboration in this context, using relational coordination as a theoretical framework. This study shows that relational coordination contributes to a greater understanding of interprofessional collaboration in the prison-welfare context, but an understanding of this phenomenon may be further developed by expanding the theory of relational collaboration, and by using other relevant theories and models. New insights are presented and illustrated, combining the theoretical and practical aspects of interprofessional collaboration.

A dissemination strategy to promote relational coordination in the veterans health administration: a case study

Background Large healthcare institutions like the Veterans Health Administration (VA) continually seek best practices to improve clinical care. Relational coordination is an evidence-based organizational theory of communicating and relating to coordinate work and drive performance outcomes. Implementing relational coordination-guided practices can be difficult due to challenges with spreading information across large systems. Using social marketing theory and evidence-based dissemination strategies, we developed an evidence-based dissemination plan to educate and motivate researchers and operational staff to study and implement relational coordination in the VA. Methods In this case study, we used the four Ps (product, price, place, promotion) of social marketing theory to develop a 2-phase dissemination strategy. In phase one, we created and distributed relational coordination information and invited VA staff to join the Relational Coordination Research Collaborative. In phase two, dissemination efforts targeted researchers ready to implement relational coordination within existing programs of research. Process and outcome measures included dissemination, engagement and adoption data and a post-project survey. Quantitative results were calculated using descriptive statistics. Survey text responses were analyzed using deductive content analysis and a structured categorization matrix. Results Phase one included social media dissemination, virtual and in-person presentations, as well as phone and email communication between project staff and the target audience. In total, 47 VA staff became members of the Relational Coordination Research Collaborative and 27 routinely participated in online research seminars. In phase 2, 13 researchers expressed interest in studying relational coordination and 5 projects were selected to participate. Multiple relational coordination-related trainings and publications originated from this program. Conclusions Dissemination approaches that involved personalized, one-on-one efforts (e.g., phone or email) seemed to be more effective at disseminating relational coordination compared to social media or online presentations. Participants in phase 2 agreed that relational coordination should be adopted in the VA but indicated that cost would be a barrier. Results support the importance of evidence-based dissemination planning that address the unique costs and benefits of programs.

Organizational Differences among Universities in Three Socioeconomic Contexts: Finland, Spain and Ecuador. Relational Coordination Approach

The knowledge of local culture is essential to establish competitive strategies in higher education. The objective of this research was to identify the organizational differences among three universities with different international contexts and satisfaction level. An approach was made regarding Relational Coordination (RC) attributes: accurate, frequent and problem-solving communication, shared knowledge, mutual respect and shared goals, by discriminant analysis method. A random sample of 300 students, 100 belonging to each university, was surveyed on the 23 RC variables in 2017–2018. First, the RC variables were evaluated by general linear model (GLM). The three universities—Arcada University of Applied Science (ARCADA) in Finland, University of Cordoba (UCO) in Spain and Agricultural Polytechnic of Manabi “MFL” (ESPAM) in Ecuador—and the two levels of student satisfaction—Low and High—were used as fixed factors. Second, a discriminant model was built with RC variables. A higher level of RC practices concerning to accurate, frequent and problem-solving communication achieved higher levels of satisfaction, regardless of the universities’ socioeconomic context. RC differentiation among three universities showed that shared goals with lecturers and administrative officers and problem-solving communication among classmates were the variables with the highest discriminant power. Two clusters were obtained, where UCO was the most differentiated university. In conclusion, organizational practices made a difference among the three universities. Discriminant analysis can be adapted and extended to different universities to improve quality.

Cross-echelon managerial design competencies: Relational coordination in organizational learning and growth performance

We followed the continuity perspective of leadership skill requirements to examine the interplay between the design competencies of different management cohorts, relational coordination, and organizational learning and growth performance outcomes. Using a two-source sample of 103 organizations, we found evidence for compensatory effects. Specifically, a conditional process analysis (moderated mediation) revealed that: (a) design competencies are a highly relevant type of managerial knowledge or skill, (b) competent middle-level managers compensate for a lack of design skills and design-related knowledge at the top management level, and (c) top- and middle-level managerial design competencies simultaneously create a cross-echelon complementarity effect on organizational learning and growth performance. JEL classification