Abstract
A core challenge of a multidisciplinary and multi-organizational translational research enterprise such as a Clinical and Translational Research Award (CTSA) is coordinating and integrating the work of individuals, workgroups, and organizations accustomed to working independently and autonomously. Tufts Clinical and Translational Science Institute (CTSI) undertook and studied a multifacted intervention to address this challenge and to create a culture of systems thinking, process awareness, responsive to others' needs, and shared decision-making. The intervention, based on relational coordination, included 1) relational interventions, in three staff retreats and a diagnostic survey to provide feedback on the current quality of relational coordination, and 2) structural interventions, in the launching of five new cross-functional teams with regular meeting structures. A mixed-methods evaluation yielded quantitative data via two types of team surveys and qualitative data via interviews and meeting observations. The findings suggest that interventions to improve relational coordination are feasible for CTSAs, including good fidelity to the model and staff/physician engagement. Survey and interview data suggest model improvements in coordination and alignment. Further research about their optimal design is warranted.
Highlights
A core challenge of a multidisciplinary and multi-organizational translational research enterprise such as a Clinical and Translational Research Award (CTSA) is coordinating and integrating the work of individuals, workgroups, and organizations accustomed to working independently and autonomously
The evaluation team found that relational meeting practices were carried out fairly consistently, with weaknesses in two areas: (1) the use of meetings as a vehicle for fostering a culture of collaboration and engagement, and (2) maintaining a culture of accountability
* Results shown in the table reflect scores for all Clinical and Translational Science Institute faculty and staff and institutional personnel who participated in the survey as well as collation members
Summary
Meeting the objectives of clinical and translational research requires the input of many stakeholders including researchers, clinicians, pharmacists, statisticians, information technology staff, educators, institutional review board members, administrators, and others. The survey assessed the quality of communicating and relating between and within workgroups as experienced by all participants and provided data to share with CTSI staff and leadership to develop an intervention. At two 3-hour Reflective Workshops, 1 each for the Education and Research Services work processes, baseline RC survey results were shared with participants in order to identify the most promising opportunities for improvement. Participants in both workshops identified shared knowledge and timely communication as the most important RC dimensions in need of improvement. These workshops were in effect relational interventions that led to identification of structural interventions as described below
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