Collaborative Behaviors in DecisionMaking: The Characteristics and the Concept

1
Collaborative Behaviors in Decision-MakingThe
Characteristics and the Concept

• Campus-Wide Leadership Series 2006
• May 5, 2006
• Mary L. Kinnaman, PhD (tomorrow!), RN
• Assistant Dean of Community Affairs
• Director of Nursing Continuing Education
• mkinnaman_at_kumc.edu

2
Objectives

• Distinguish between collaborative and
  non-collaborative behaviors.
• Explore the relationship between the functions of
  teams and groups as decision-making entities.
• Relate how "leadership" and "management"
  functions shape the nature and types of decisions
  to be made.
• Critique the use or non-use of theory in guiding
  teams toward effective decision-making.

3
Toleration

• Toleration behaviors are sublimated automatic
  responses associated with decision-making in high
  certainty/high agreement events.

4
Coordination

• Coordination is defined as two or more people
  providing services to a client or program
  separately and informing each other of their
  activities.

5
Cooperation

• Cooperation is defined as people actively working
  together for mutual benefit. With cooperation
  there are shared objectives. There is also
  maintenance of distinct and individual
  professional identities.

6
Collaboration

• A process that fosters innovation and advanced
  problem solving among people who
• Are of different disciplines, organizational
  ranks, or institutional settings
• Band together for advanced problem solving
• Discern innovative solutions without regard to
  discipline, rank, or institutional affiliation
• Enact change based on a higher standard of care
  or organizational outcomes.
• 
  (Kinnaman Bleich, 2004)

7
Collaboration

• The process requires mutual respect, differing
  but complementary competencies, a distributive
  balance of power between the parties, and
  evidence of satisfying teamwork that results in
  change.
  (Kinnaman Bleich, 2004)

8
What is a team?

• A team is a small number of people with
  complementary skills who are committed to a
  common purpose, set of performance goal, and
  approach for which they hold themselves mutually
  accountable.
• (Katzenbach Smith, 1993, p. 111)

9
Not All Groups Are Teams How to Tell the
Difference

• Working Group
• Strong, clearly focused leader
• Individual accountability
• The groups purpose is the same as the broader
  organizational mission
• Individual work-products
• Runs efficient meetings
• Measures its effectiveness indirectly by its
  influence on others (e.g., financial performance
  of the business.)
• Discusses, decides, and delegates.

• Team
• Shared leadership roles
• Individual and mutual accountability
• Specific team purpose that the team itself
  delivers
• Collective work-products
• Encourages open-ended discussion and active
  problem-solving meetings
• Measures performance directly by assessing
  collective work-products
• Discusses, decides, and does real work together.

10
TEAM ADDS VALUE THROUGH PEOPLE

• Improved..
• worker morale (more fun)
• productivity (lt 30)
• communication
• conflict resolution
• problem solving
• learning
• discipline
• speed acceptance of change

11
Team Basics
Katzenback, J.R., Smith, D. K. (1993). The
Wisdom of Teams. New York HarperBusiness.
PERFORMANCERESULTS
Problem solving Technical/
functionInterpersonal
MutualSmall number of peopleIndividual
SKILLS
ACCOUNTABILITY
Specific goalsCommon approachMeaningful purpose
PERSONAL GROWTH
COLLECTIVE WORK PRODUCTS
COMMITMENT
12
Stages of Team Development
BEHAVIOR
RELATIONSHIP
STAGE
THEME
TASK
1. FORM
Awareness
Orientation
Dependency
2. STORM
Conflict
Resistance
Hostility
3. NORM
Cooperation
Communication
Cohesion
Problem solving
Productivity
Interdependence
4. PERFORM
5. ADJOURN / REFORM
Separation
Celebration
Closure
13
COLLECTION
TEAM
WORK GROUP
EmployeeGrowthStage ManagementRole HumanAn
alogy
Dependent
Interdependent
Independent
M
M
M
Tell
Influence
Collaborate
Adolescent
Child
Adult
14
Performing The High-Performing Team

• Synergy Requires
• Appropriate leadership
• Alignment of purpose
• High communication and trust
• Commitment to team
• Constructive climate
• Effective work methods
• Strong team organization
• Flexibility
• Growth-oriented individuals
• Creative strength
• Ambassadors

15
A few findings from research

• Participation rates and shared decision-making in
  teams correlated with patient outcomes
• Decision-making consistency decreases as the
  complexity of the problem increases
• Time and expertise influence the appropriateness
  of decisions about discharge referrals
• The clinical microsystems studies identified
  characteristics for decision-making from
  best-of-best sites
• Leadership was identified as a key success
  characteristic of best-of-best clinical
  microsystems

16
Premise 1

• "Things should be made as simple as possible, but
  not any simpler.
• Einstein

17
Premise 2 We believe what we see
see believe----------
-----
Data (Input)
Dominant Logic acts as a FILTER
System Learning (Output)
Begun, 1995
18
Premise 3

• Insanity is doing the same thing over and over
  and expecting different results.
  
  Einstein

19
Premise 4

• Status-driven hierarchical processes undermine
  analysis and problem-solving activities in teams.
  Paradoxically these same processes may
  facilitate coordination (Ingersoll Schmitt,
  2004)

20
Three Leadership Trends

• Leading health care organizations will require a
  great tolerance for ambiguity, an appetite for
  novelty, and a capacity to act even when facing
  great uncertainty.
• Leaders will need to look outside their own
  sectors and disciplines for insights and ideas on
  adaptability and sustainability of health care
  organizations.
• Relationships are everything.

Zimmerman, 1999, p. 42
21
Self-Organizing Dynamics
System Agents Ideas, People, Departments,
Clients/Customers, Individual Actions, and so on
Emergent Patterns Mental models, teams, delivery
systems, target populations, culture, and so on
22
What is the leaders role?
The most critical aspect of leadership is the
desire and passion to lead, the capacity to
deeply reflect on and learn from leadership
activities, a willingness to step out of ones
comfort zone, and the ability to build and use
RELATIONSHIPS for some constructive good.
Mikes Maxim
23
Some Readings

• Gladwell, M. (2004). Blink The power of thinking
  without thinking. New York Time Warner
  AudioBooks.
• Wheatley, M. J. (1999). Leadership and the new
  science Discovering order in a chaotic world
  (2nd ed.). San Francisco Berrett-Koehler
  Publishers.
• Zimmerman, B. (1999). Complexity science A route
  through hard times and uncertainty. Health Forum
  Journal, 42(2), 42-46, 69.
• Zimmerman, B., Lindberg, C., Plsek, P. (2001).
  A complexity science primer What is complexity
  science and why should I learn about it? In
  Edgeware Insights from complexity science for
  health care leaders. Dallas VHA Inc. (available
  online at the Plexus site)