Relational Coordination Theory Research Articles

Seeing the Whole Together Through Relational Mapping: A Method for Engaging in Complex Systems Change

Complex global challenges cut across organizational and sectoral boundaries, increasing calls for holistic responses. Seeing the whole across diverse stakeholders is challenging for participants in complex systems, yet doing so is essential for engaging effectively in systems change. A promising new method known as relational mapping, based on relational coordination theory, has been used to facilitate complex systems change. Here, we propose that relational mapping can be applied to help participants (1) see the whole in relation to the parts, (2) share their explicit and tacit knowledge, (3) engage in dialogue across distinct perspectives supported by the map as a boundary object, (4) reduce the impact of power differences, and (5) prepare to co-design interventions from multiple perspectives. This paper presents an illustrative case of relational mapping in the context of public administration in a South Carolina community engaging in complex systems change. Our analysis suggests a set of boundary conditions for the success of relational mapping, including the willingness of participants to seek integrative solutions to a conflict or problem and facilitation that is attentive to differential power and status among stakeholders. We conclude that relational mapping is a powerful, theoretically grounded method that enables the visual assessment of multi-level stakeholder relationships, preparing participants to engage in complex systems change and then present a template for use of relational mapping more broadly.

Exploring new frontiers of experiential learning landscape: a hybrid review

PurposeExperiential learning is crucial in education, as it offers hands-on, practical experiences that enable individuals to develop their skills and knowledge more engagingly and interactively. In recent years, experiential learning has become a significant aspect of education. To provide academic scholars with a thorough roadmap for further investigation, this study aims to provide useful insights into the bibliometric and content analysis of experiential learning, including keywords, well-known authors, publications, nations and topics.Design/methodology/approachThis research does a rigorous bibliometric analysis to give a thorough and visually instructional assessment of the evolution and advancement of the literature on experiential learning. Its fast development between 1976 and 2022 is meticulously tracked in the research. By using VOSviewer and Biblioshiny tools, the present study presents a concise overview of 507 records retrieved from the Scopus database using the keyword “Experiential Learning”, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. Deeper text mining was done using Python libraries “Pandas” and “Natural Language Toolkit” and regular expressions.FindingsThe findings reveal a surge in the number of publications on experiential learning and provide insights, particularly using the theory, context, characteristics, methodology analysis, supporting researchers and practitioners to understand learning better and provide perspectives for future research. Descriptive bibliometric analysis showed that most contributions are from the USA, the UK and Canada. In-depth content analysis revealed five clusters: developments in learning, management education, engineering curricula, organisational learning and knowledge management and entrepreneurship education. The keyword co-occurrence analysis enabled linkages between relevant fields of study and significant research domains. The most commonly used theories were: experiential learning theory, social learning theory, relational coordination theory, empowerment theory, feedback learning theory, effectuation theory and human capital theory.Originality/valueThis study uses information from the Scopus database to do a bibliometric analysis of experiential learning from 1976 to 2022. This study serves as a valuable resource for researchers in the field, helping them to position their work more explicitly within the existing literature and highlighting potential areas for future research. It does this by thoroughly analysing the literature on experiential learning using bibliometrics.

An examination of social relations and concussion management via the blue card.

Initially developed by New Zealand Rugby in 2014, the Blue Card initiative in rugby enables match officials to remove athletes from play if they are suspected to have sustained a concussion. Considerable attention has been paid by sport and health advocates to the possibilities and limitations of this initiative in safeguarding athlete health. However, little if any attention has been paid to the well-being of those responsible for administering the Blue Card (i.e., match officials). The aim of this paper was to examine match officials' experiences with and perspectives on implementing the Blue Card initiative in Ontario, Canada, with focused attention on the tensions around their ability to manage games and participants (e.g., athletes, coaches) while attempting to safeguard athlete well-being. Using Relational Coordination Theory (RCT) as a guiding framework and qualitative research method, we highlight the rich accounts of 19 match officials' perspectives and experiences regarding sport-related concussion (SRC) management and the Blue Card protocol. Four themes were derived from the data, reflecting latent assumptions embedded within the concussion management process, which include: assumptions of trust, respect, and cooperation; assumptions of shared responsibility; assumptions of shared understanding; and assumptions of harassment-free sport. Our findings emphasize the need to attend to social relations in concussion management and provide insight into match officials' fraught experiences on the frontlines of concussion management. We identify factors affecting match official well-being and provide considerations for concussion management initiatives designed to improve athlete safety, such as the Blue Card.

Digitally-mediated coordination in healthcare: the effects of teleconsultation on doctor-to-doctor relational coordination

BackgroundDigitalization transforms the way in which interdependent work is coordinated, especially in healthcare settings. This work deepens the effect of teleconsultation use on health professionals’ coordination. For this aim, we rely on Relational Coordination Theory (RCT), which explores coordination as an interactive process among group participants within the context of task interdependency.MethodsWe collected data through an online survey administered to Italian specialist doctors between March and April 2023. 489 complete answers were gathered. Hypotheses have been tested through Structural Equation Modelling.ResultsWe found that teleconsultation frequency of use has a positive and significant effect on both components of relational coordination, confirming our hypotheses.ConclusionsTheoretically, this research contributes to our understanding of the effect of digitally mediated coordination mechanisms on relational coordination. In practice, we shed light on the organizational implications of telemedicine under a novel perspective, focusing on the role of professional interactions in digitally mediated work and providing useful elements for the organizational design of telemedicine.

Improving safety and preventing falls using an evidence-based, front-line staff huddling practice: protocol for a pragmatic trial to increase quality of care in State Veterans Homes

IntroductionFalls in nursing homes are a major cause for decreases in residents’ quality of life and overall health. This study aims to reduce resident falls by implementing the LOCK Falls...

The Process of Changes in Interprofessional Work in Hospital Discharge Support: Action Research Based on Relational Coordination Theory

The Process of Changes in Interprofessional Work in Hospital Discharge Support: Action Research Based on Relational Coordination Theory

The Association of Relational Coordination and Faculty Members' Burnout and Job Satisfaction: A Preliminary Cross-Sectional Study

Introduction. The relational coordination theory describes the interaction between effective communication and high-quality relationships critical for coordinating and accomplishing tasks when multiple individuals and groups are involved. Review of Literature. Relational coordination is associated with improved worker performance, increased job satisfaction, and reduced burnout. The purposes of this paper were to examine the differences in physical therapist education program (PTEP) core faculty members' perceived relational coordination with other PTEP faculty members, staff, and administration and to examine the associations between PTEP core faculty members' perceived relational coordination and its subscales and their perceived burnout and job satisfaction. Subjects. Entry-level PTEP core faculty members. Methods. An online survey that included the Relational Coordination Survey, Oldenburg Burnout Inventory, and Job Satisfaction Survey was used. A 1-way analysis of variance was conducted to test whether there were differences in PTEP core faculty members' perceived relational coordination with other PTEP faculty members, staff, and administration. Several simple linear regressions were conducted to test the associations between PTEP core faculty members' perceived relational coordination and its subscales and their perceived burnout and job satisfaction. Results. A total of 103 responses were analyzed. The PTEP core faculty members' mean perceived relational coordination with core faculty members was significantly higher than the mean relational coordination with associated faculty members, administration, and staff. Physical therapist education program core faculty members' perceived relational coordination and all its subscales were negatively associated with perceived disengagement. Perceived problem-solving communication and mutual respect were negatively associated with perceived exhaustion. Physical therapist education program core faculty members' perceived relational coordination and all its subscales were positively associated with perceived job satisfaction. Discussion and Conclusion. The quality of communication and relationships between and among core faculty members, administrators, and staff may affect PTEP core faculty members' perceived burnout and job satisfaction.

The relationship of internal auditors’ characteristics with external auditors’ reliance and its impact on audit efficiency: Empirical evidence from Indonesian government institutions

Previous studies have separately investigated the relationship between the internal auditors’ characteristics, the level of external auditors’ reliance, and the audit efficiency so it has not fully described how the external auditors make decisions to rely on internal audit work, which has an impact on audit efficiency. Therefore, the current study aims to fill the research gap by analyzing the relationship among the internal auditors’ characteristics, external auditors’ reliance and audit efficiency in one comprehensive research model with the institutional environment as a moderating variable in the relationship between the level of external auditors’ reliance and the audit efficiency. This study is conducted in government organizations with the consideration that the reliance of external auditors on internal audit work is one of the strategies for dealing with the limited resources faced by government external auditors in Indonesia. Surveys are conducted to collect research data. The research subjects are 164 external auditors (BPK) from 34 representative offices in Indonesia. The data are analyzed using Partial least Square-Structural Equation Modeling. The results of this study show that the level of external auditors’ reliance on internal audit work has a significant effect on audit efficiency. Furthermore, the results also show that there is a moderating effect of the institutional environment on the relationship between the level of external auditors’ reliance and audit efficiency. This study contributes to the application and development of relational coordination theory and institutional theory in accounting and auditing fields, especially in government sector audits.

Relational Coordination Among Service Providers

This paper seeks to identify a potential mechanism over which HPWS influences performance. Using relational coordination theory, this paper assesses communication and relational ties of relational coordination as a potential link over which HPWS can affect unit-level performance in banks which are characterized as highly uncertain, interdependent, as well as time-bound. Primary data were collected from bank officers about the strength of HPWS and relational coordination among employees. Results indicate that HPWS was significantly associated with bank performance outcomes, including branch levels of deposits, loans, and net profit. Results also indicate that RC significantly mediated the linkages between HPWS and unit-level performance outcomes. These results suggest new insights for top management and HR leaders in the banking industry regarding the design of HPWS.

Effective communication for relational coordination in remote work: How job characteristics andHRpractices shape user–technology interactions

AbstractThe theory of relational coordination holds that frequent, timely, accurate, and problem‐solving communication positively interacts with relationships of mutual respect, shared goals, and shared knowledge to support effective work coordination. With increasing numbers of employees working remotely, Advanced Communication Technologies (ACTs) are crucial for enabling the communication necessary for relational coordination. To investigate how organizations can maintain effective communication between employees in remote work settings, we conducted 47 interviews across multiple organizations. We find that users enact different affordances, that is, action possibilities, of the same material features of an ACT. Enacting these affordances supports frequent, timely, accurate, and problem‐solving communication when working remotely. Which affordances users enact varies systematically with job characteristics. Specifically, users whose jobs have high levels of task variety, autonomy, creative problem solving, and interdependence across teams enact more of the affordances that enable effective communication. Comprehensive ACTs that integrate all communication features into one technology and rules requesting the company‐wide exclusive interaction with this ACT strengthen the relationship between users' job characteristics and affordance enactment. Our findings show that it is important to involve HRM from the outset so that, in close cooperation with IT, a system can be found that—supported by suitable sets of rules—enables effective communication.

Interprofessional team-based collaboration between designated GPs and care home staff: a qualitative study in an urban Danish setting

BackgroundBeing a general practitioner for residents in many care homes may challenge communication with residents, relatives, and care home staff, and potentially lead to lower quality of care. Several countries have therefore introduced different solutions to reduce the number of general practitioners at each care home. In 2017, the designated general practitioner model was introduced at many Danish care homes. This study aimed to evaluate experiences from the interprofessional team-based collaboration between designated general practitioners and care home staff with regular contact with the designated general practitioners in an urban Danish setting.MethodsA qualitative design was applied using semi-structured interviews. Eight interviews (three group interviews and five individual interviews) were conducted with four designated general practitioners and seven care home staff members at four care homes in an urban setting of Central Denmark Region, Denmark. The interviews were transcribed verbatim, and data were analysed using content analysis with inspiration from the theory of relational coordination. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework.ResultsThe initiation of the designated general practitioner model was experienced to contribute to more clear, precise, and timely communication between care homes and the general practitioner. An improved mutual acknowledgement of roles and competencies was experienced between designated general practitioners, care home nurses, and sometimes also social and health care assistants. The more frequent visits by the general practitioners at the care homes, as a result of the designated general practitioner model, resulted in more face-to-face communication between care home staff and designated general practitioners. Professional differences in the interpretation of the patient’s needs were still present, which at times caused a frustrating compromise of own professional competencies. An important reason for the overall perception of improved collaboration was attributed to the more frequent dialogue in which the care homes staff and the designated general practitioners exchanged knowledge that could be applied in future patient encounters.ConclusionThe designated general practitioner model implied an improved collaboration between general practitioners and care homes staff. Clear, precise, and timely communication between care homes and the general practitioners, as well as mutual trust and acknowledgement was experienced to be essential for the collaboration. An important reason for the overall perception of an improved collaboration was attributed to the more frequent dialogue (more frequent general practitioner visits at the care homes) in which the care homes staff and the designated general practitioners exchange knowledge which again could be applied in future patient encounters.

Development and validation of a scale to measure team communication behaviors.

With the COVID-19 pandemic, remote work was increased all over the globe. As a consequence, workers had to adapt their communication behaviors to smoothly coordinate work in their flexible teams (i.e., when team members divide work between the office and their homes). Drawing on relational coordination theory, we constructed and validated a scale to capture the most relevant team communication behaviors. We employed interviews and focus groups to construct the scale, refined the scale based on three samples with employees working flexibly and finally validated the scale with 130 teams from diverse organizations. Our scale comprises three dimensions: focused communication, knowledge sharing and spontaneous communication. All three dimensions showed convergent validity with team planning and discriminant validity with time-spatial flexibility. Also, predictive validity with collective efficacy and team viability was achieved for focused communication and knowledge sharing. Spontaneous communication only predicted collective efficacy, but not team viability. We conclude that the TCS is a reliable and valid measure for assessing team communication and contribute by focusing on behaviors.

The impact of clinical pharmacist-physician communication on reducing drug-related problems: a mixed study design in a tertiary teaching Hospital in Xinjiang, China

BackgroundThe incidence of drug-related problems (DRPs) has caused serious health hazards and economic burdens among polymedicine patients. Effective communication between clinical pharmacists and physicians has a significant impact on reducing DRPs, but the evidence is poor. This study aimed to explore the impact of communication between clinical pharmacists and physicians on reducing DRPs.MethodsA semistructured interview was conducted to explore the communication mode between clinical pharmacists and physicians based on the interprofessional approach of the shared decision-making model and relational coordination theory. A randomized controlled trial (RCT) was used to explore the effects of communication intervention on reducing DRPs. Logistic regression analysis was used to identify the influencing factors of communication.ResultsThe mode of communication is driven by clinical pharmacists between clinical pharmacists and physicians and selectively based on different DRP types. Normally, the communication contents only cover two (33.8%) types of DRP contents or fewer (35.1%). The communication time averaged 5.8 minutes. The communication way is predominantly face-to-face (91.3%), but telephone or other online means (such as WeChat) may be preferred for urgent tasks or long physical distances. Among the 367 participants, 44 patients had DRPs. The RCT results indicated a significant difference in DRP incidence between the control group and the intervention group after the communication intervention (p = 0.02), and the incidence of DRPs in the intervention group was significantly reduced (15.6% vs. 0.07%). Regression analysis showed that communication time had a negative impact on DRP incidence (OR = 13.22, p < 0.001).ConclusionThe communication mode based on the interprofessional approach of the shared decision-making between clinical pharmacists and physicians in medication decision-making could significantly reduce the incidence of DRPs, and the length of communication time is a significant factor. The longer the communication time is, the fewer DRPs that occur.Trial registrationThis trial was approved by the ethics committee of The First Affiliated Hospital of Medical College of Xinjiang Shihezi University Hospital (kj2020–087-03) and registered in the China clinical trial registry (https://www.chictr.org.cn, number ChiCTR2000035321 date: 08/08/2020).

How Job Design Shapes Effective Communication for Relational Coordination in Remote Work.

The theory of relational coordination proposes that frequent, timely, accurate and problem solving communication foster relationships of mutual respect, shared goals and shared knowledge, and vice versa, and that these dimensions support effective work coordination. With increasing numbers of employees working remotely, Advanced Communication Technologies (ACTs) play a crucial role for fostering communication necessary for relational coordination. Analysing data on user-ACT-interaction from semi-structured interviews, we find that the same material features of an ACT can lead to contrasting affordances or constraints, explaining employees’ varying ability to maintain frequent, timely, accurate and problem solving communication. The HR practice of job design influences, which affordances or constraints users’ perceive by shaping physical, task and relational characteristics of a job. Specifically, the early introduction of a comprehensive ACT that integrates various features into one technology, the existence of interdependent tasks that require frequent and ad hoc exchanges, the embeddedness in larger cross-departmental networks and a team context valuing face-to-face interactions foster the perception of affordances underlying effective communication.

Adaptations to relational facilitation for two national care coordination programs during COVID-19.

Adaptations to implementation strategies are often necessary to support adoption and scale-up of evidence-based practices. Tracking adaptations to implementation strategies is critical for understanding any impacts on outcomes. However, these adaptations are infrequently collected. In this article we present a case study of how we used a new method during COVID-19 to systematically track and report adaptations to relational facilitation, a novel implementation strategy grounded in relational coordination theory. Relational facilitation aims to assess and improve communication and relationships in teams and is being implemented to support adoption of two Quadruple Aim Quality Enhancement Research Initiative (QA QUERI) initiatives: Care Coordination and Integrated Case Management (CC&ICM) and the Transitions Nurse Program for Home Health Care (TNP-HHC) in the Veterans Health Administration (VA). During 2021-2022, relational facilitation training, activities and support were designed as in-person and/or virtual sessions. These included a site group coaching session to create a social network map of care coordination roles and assessment of baseline relationships and communication between roles. Following this we administered the Relational Coordination Survey to assess the relational coordination strength within and between roles. COVID-19 caused challenges implementing relational facilitation, warranting adaptations. We tracked relational facilitation adaptations using a logic model, REDCap tracking tool based on the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) with expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) dimensions, and member checking. Adaptations were analyzed descriptively and for themes using matrix content analysis. COVID-19's impact within the VA caused barriers for implementing relational facilitation, warranting eight unique adaptations to the implementation strategy. Most adaptations pertained to changing the format of relational facilitation activities (n = 6; 75%), were based on external factors (n = 8; 100%), were planned (n = 8; 100%) and initiated by the QA QUERI implementation team (n = 8; 100%). Most adaptations impacted adoption (n = 6; 75%) and some impacted implementation (n = 2; 25%) of the CC&ICM and TNP-HHC interventions. Systematically tracking and discussing adaptations to relational facilitation during the COVID-19 pandemic enhanced engagement and adoption of two VA care coordination interventions. The impact of these rapid, early course adaptations will be followed in subsequent years of CC&ICM and TNP-HHC implementation.

Strengthening Community Participation by People With Disabilities in Community-Based Group Homes Through Innovative Action Research

In the US and beyond, a paradigm shift is underway toward community-based care, motivated by changes in policies, payment models and social norms. A significant aspect of this shift for disability activists and policy makers is ensuring participation in community life for individuals with disabilities living in residential homes. Despite a U.S. government ruling that encourages community participation and provides federal and state funding to realize it, little progress has been made. This study builds on and integrates the expanded model of value creation with relational coordination theory by investigating how the resources and relationships between care providers, adults with disabilities, family members, and community members can be leveraged to create value for residents through meaningful community participation. The purpose of our community case study was to assess and improve the quality of relationships between stakeholder groups, including direct care staff and managers, residents, family members, and the community through an action research intervention. This study took place in a residential group home in a Northeastern US community serving adults with disabilities from acquired brain injury. A pre-test post-test design was used and quantitative assessments of relational coordination were collected through electronic surveys, administered at baseline, and post-intervention. Direct care staff, supervisors, the house manager, and nursing staff completed the survey. Qualitative data were collected through focus groups, change team meetings, and key informant interviews. Direct care staff formed a change team to reflect on their baseline relational coordination data and identified the weak ties between direct care staff, family members, and the community as an area of concern. Staff chose to hold a community-wide open house to provide an opportunity to foster greater understanding among staff, residents, family, and community members. The change team and other staff members coordinated with local schools, business owners, town officials, churches, and neighbors. The event was attended by 50 people, about two-thirds from the community. Following the intervention, there was an increase in staff relational coordination with the community. While statistical significance could not be assessed, the change in staff RC with the community was considered qualitatively significant in that real connections were made with members of the community both directly and afterwards. Despite a small sample size, a residential setting where management was favorable to initiating staff-led interventions, and no comparison or control group, our small pilot study provides tentative evidence that engaging direct care staff in efforts to improve relational coordination with community members may succeed in building relationships that are essential to realizing the goal of greater participation in community life.

Thematic mapping of perioperative incident reporting data to relational coordination domains

ABSTRACT Communication failure is a common root cause of adverse clinical events. Problematic communication domains are difficult to decipher, and communication improvement strategies are scarce. This study compared perioperative incident reports (IR) identifying potential communication failures with the results of a contemporaneous peri-operative Relational Coordination (RC) survey. We hypothesised that IR-prevalent themes would map to areas-of-weakness identified in the RC survey. Perioperative IRs filed between 2018 and 2020 (n = 6,236) were manually reviewed to identify communication failures (n = 1049). The IRs were disaggregated into seven RC theory domains and compared with the RC survey. Report disaggregation ratings demonstrated a three-way inter-rater agreement of 91.2%. Of the 1,049 communication failure-related IRs, shared knowledge deficits (n = 479, 46%) or accurate communication (n = 465, 44%) were most frequently identified. Communication frequency failures (n = 3, 0.3%) were rarely coded. Comparatively, shared knowledge was the weakest domain in the RC survey, while communication frequency was the strongest, correlating well with our IR data. Linking IR with RC domains offers a novel approach to assessing the specific elements of communication failures with an acute care facility. This approach provides a deployable mechanism to trend intra- and inter-domain progress in communication success, and develop targeted interventions to mitigate against communication failure-related adverse events.

Learning to listen: Downstream effects of listening training on employees' relatedness, burnout, and turnover intentions

AbstractThe present work focuses on listening training as an example of a relational human resource practice that can improve human resource outcomes: Relatedness to colleagues, burnout, and turnover intentions. In two quasi‐field experiments, employees were assigned to either a group listening training or a control condition. Both immediately after training and after 3 weeks later, receiving listening training was shown to be linked to higher feelings of relatedness with colleagues, lower burnout, and lower turnover intentions. These findings suggest that listening training can be harnessed as a powerful human resource management tool to cultivate stronger relationships at work. The implications for Relational Coordination Theory, High‐Quality Connections Theory, and Self‐Determination Theory are discussed.

Advancing Interorganizational Crime and Violence Reduction Goals Through a Relational Change Intervention

Effective interorganizational collaboration is deemed essential to comprehensive crime and violence initiatives but rarely is it empirically assessed. An 18-month intervention to improve collaboration Comprehensive Gang Model (CGM) locations was used in this study to examine the impact on increasing community capacity to address gangs and violence and reducing gang and violence in the community. Relational coordination theory grounded the collaboration intervention. Results from the quasi-experimental design showed significant, increased collaboration and reduction in violent crime in one intervention site. Other crime reduction efforts were explored as counterfactuals. Matched comparison sites saw no change in the ability to work together or violence reduction. Study implications are that relational coordination interventions may facilitate the goal of working better together, but parallel evaluations for each of the five core CGM strategies are needed to understand the independent effects of each strategy on gang and violence reduction goals.

Shaping Better Rehabilitation to Chronic Obstructive Pulmonary Disease Patients: Experiences of Nurses and Colleagues With an Interdisciplinary Telerehabilitation Intervention

In order to evaluate the reach of a collaborative cross-sectoral telerehabilitation intervention to patients with Chronic Obstructive Pulmonary Disease (COPD), this study investigates how nurses and interdisciplinary colleagues experienced working with it. In two focus group interviews, the experiences of working in the empowerment and tele-based >C☺PD-Life>> program were examined among three nurses and four interdisciplinary colleagues. Data were analyzed with inspiration from Ricoeur’s theory of narrative and interpretation and discussed with Gittell’s theory of relational coordination. Nurses and colleagues experienced that the intervention paved the way for unique patient-professional coordination and interdisciplinary cross-sectoral teamwork that allowed double-layered relational coordination, focusing holistically on patients’ lived challenges in everyday life with COPD. By this rehabilitation setup, nurses and colleagues are perceived as educated to deliver high standard personalized support, raising professional pride and confidence. The findings can inspire future health-promoting initiatives within nursing support related to patients afflicted with COPD.