Session: Rules of engagement for strengthening interdisciplinary partnerships

Editor's Note

In this session, Robin Kaufman, DNP, APRN, FNP-C, NEA-BC, associate chief nurse, perianesthesia, procedural, and ambulatory services at Brigham and Woman’s Faulkner Hospital (BWFH), and Jeffrey Blackwell, MHA, FACHE, senior director, perioperative business operations, at UMass Memorial Medical Center, tackled how to strengthen interdisciplinary partnerships via co-leadership and shared governance.

The interdisciplinary partnership presented includes both clinical and administrative staff: physicians, nurses, and hospital administrators. The clinical partner is who leads clinical transformation, said the presenters. Clinicians are change agents and advocates who foster evidence-based care and seek teamwork, productivity, and compliance, among other quality-driven goals. The administrative partner, on the other hand, optimizes the business by crafting strategies and growth plans. Administrators ensure efficiency in operations, financial planning, supply chain, capital deployment, and more.

These might sound like opposing views on paper, but the two sides have goals that are “more alike than different,” said the presenters. The above duties complement each other to drive safety and efficiency—and such an alliance brings together leaders “at the top of license” of “different skill sets, education, and background.”

“Co-leadership also reduces leader burnout,” said Kaufman. “Leaders are also feeling burned out, not just staff.” But she warns that forming these partnerships requires the right approach and might have a negative impact if not done well.

“There are different motivations and pathways to leadership at play here,” Kaufman continued. Clinicians, for instance, rise to leadership due to clinical competencies and skills, whereas non-clinical administrators might have had years of mentorship/apprenticeship throughout their careers. “And the concept of going backwards is foreign to most clinicians,” she said. “If you are unhappy in a leadership role, no one shows you how to return to a position where you were satisfied and competent.”

Leveraging these diverse, albeit complementary, perspectives can be challenging due to distrust, entrenched world views, and pre-set roles and expectations. One way to bridge the gap is to be patient, flexible, and welcoming. Administrators should go to clinical areas and talk to staff, and nurses/physicians should be invited to meetings and have a say.

“Our shared governance framework is a bi-directional flow structure,” Blackwell said. The meetings are split into 3 groups: OR executive committee, perioperative management, and perioperative operations. Each group has a couple of people in common with the next group who are conduits for information. Attendees got to visualize the breakdown of each group; the structure of successful meetings; and the leadership tools that have proven useful to the presenters.

“The biggest challenge initially was finding time for the meetings among the different stakeholders,” said Blackwell. “But once we figured it out—and it took a while—we saw great success.”