Skip to Main Content
HBS Home
  • About
  • Academic Programs
  • Alumni
  • Faculty & Research
  • Baker Library
  • Giving
  • Harvard Business Review
  • Initiatives
  • News
  • Recruit
  • Map / Directions
Working Knowledge
Business Research for Business Leaders
  • Browse All Articles
  • Popular Articles
  • Cold Call Podcast
  • Managing the Future of Work Podcast
  • About Us
  • Book
  • Leadership
  • Marketing
  • Finance
  • Management
  • Entrepreneurship
  • All Topics...
  • Topics
    • COVID-19
    • Entrepreneurship
    • Finance
    • Gender
    • Globalization
    • Leadership
    • Management
    • Negotiation
    • Social Enterprise
    • Strategy
  • Sections
    • Book
    • Podcasts
    • HBS Case
    • In Practice
    • Lessons from the Classroom
    • Op-Ed
    • Research & Ideas
    • Research Event
    • Sharpening Your Skills
    • What Do You Think?
    • Working Paper Summaries
  • Browse All
    Improving Patient Outcomes: The Effects of Staff Participation and Collaboration in Healthcare Delivery
    14 Aug 2007Working Paper Summaries

    Improving Patient Outcomes: The Effects of Staff Participation and Collaboration in Healthcare Delivery

    by Ingrid M. Nembhard, Anita L. Tucker, Jeffrey D. Horbar and Joseph H. Carpenter
    Health-care organizations have a well-documented, industry-wide need to improve their processes. To that aim, the Institute of Medicine has made at least 2 recommendations that focus on front-line staff—physicians, nurses, and respiratory therapists. The first recommendation states that front-line staff should be involved in unit decision-making and the design of work processes and workflow (participation). The second emphasizes respectful interactions among front-line staff, including information-sharing and coordinating activities to achieve organizational goals (collaboration). This study provides preliminary supporting evidence for the Institute of Medicine's recommendations to use a dual, front-line strategy of participation and collaboration to improve patient outcomes. Key concepts include:
    • Shared decision-making and respectful collaboration are vital to enabling improvement in health-care organizations.
    • Front-line staff participation in process improvement can solve a common problem: lack of commitment from health-care professionals to implement new practices.
    • Units with more collaboration—as measured by staff perception and use of collaborative work practices—experienced greater improvement in risk-adjusted mortality among patients.
    • Participation in process improvement may be an effective strategy for other service organizations that face staff resistance to new routines.
    LinkedIn
    Email

    Author Abstract

    Front-line staff possess an immense amount of functional and experiential knowledge from which their organizations can learn. This paper examines two distinct processes for leveraging front-line staff knowledge in organizational learning—participation and collaboration. Participation describes front-line staff sharing decision-making authority with hierarchical superiors (e.g., managers). Collaboration refers to front-line staff respectfully working together by sharing information and coordinating activities to achieve a goal. Using a sample of hospital intensive care units, we found beneficial effects of front-line staff participation and collaboration on organizational performance, as measured by improvement in risk-adjusted unit mortality. However, the positive effects had contingencies. Participation's effect was contingent on the type of participation. Participation in daily unit management had no effect on unit mortality, while participation in process improvement was positively related to improvement in unit mortality. The positive relationship between collaboration and improvement in mortality was greater for units with larger staff sizes. The implications of these findings for organizational learning, process improvement and human resource management are discussed.

    Paper Information

    • Full Working Paper Text
    • Working Paper Publication Date: July 2007
    • HBS Working Paper Number: 08-002
    • Faculty Unit(s): Technology and Operations Management
      Trending
        • 16 Mar 2023
        • Research & Ideas

        Why Business Travel Still Matters in a Zoom World

        • 04 Sep 2001
        • Research & Ideas

        Is Government Just Stupid? How Bad Decisions Are Made

        • 25 Jan 2022
        • Research & Ideas

        More Proof That Money Can Buy Happiness (or a Life with Less Stress)

        • 25 Feb 2019
        • Research & Ideas

        How Gender Stereotypes Kill a Woman’s Self-Confidence

        • 14 Mar 2023
        • In Practice

        What Does the Failure of Silicon Valley Bank Say About the State of Finance?

    Find Related Articles
    • Organizational Design
    • Employees
    • Health Care and Treatment
    • Health

    Sign up for our weekly newsletter

    Interested in improving your business? Learn about fresh research and ideas from Harvard Business School faculty.
    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
    ǁ
    Campus Map
    Harvard Business School Working Knowledge
    Baker Library | Bloomberg Center
    Soldiers Field
    Boston, MA 02163
    Email: Editor-in-Chief
    →Map & Directions
    →More Contact Information
    • Make a Gift
    • Site Map
    • Jobs
    • Harvard University
    • Trademarks
    • Policies
    • Accessibility
    • Digital Accessibility
    Copyright © President & Fellows of Harvard College