Relational Coordination – can changes in cooperation and relationships be measured

Abstract

Relational coordination has received much attention both in a political and a research perspective. The health care sector has found relational coordination interesting after the book High Performance Healthcare (Gittell, 2009) showed a correlation between relational coordination and surgical performance. The book argues for causality, so that relational coordination is a shortcut to better quality of treatment while offering improved job satisfaction at the same time. However, there is very little knowledge about what relational coordination is or how it is effective in a change project. Likewise, there is little knowledge about how the questionnaire measures relational coordination; how sensitive is it, and what is it really measuring. This article is based on a project called “From concept to the bottom line – how can we increase relational coordination?” which was financed by Centre for Social Leadership (Edwards, 2014). The project included 11 change projects in hospital wards in Region North and at Glostrup Hospital. Relational coordination was measured before and after the change in each of these 11 projects. A change could e.g. be a new way to conduct rounds. Each project included a leader interview in the beginning of the project and a chronicle workshop at the end of the project. Chronicle workshop was to provide insight into changes in processes, equipment and working relationships. In the 11 projects, 389 people completed the questionnaire before and 366 people after. The response rate ranged from 38% – 90%. Overall, there is a very weak develop- ment of relational coordination, which is in sharp contrast to the chronicle workshop, which recounts significant changes in daily life and organisation. The article concludes that the relational coordination questionnaire has difficulties in measuring changes in cooperation and relations, and that the changes have to be rather big for it tobe measured on the relational coordination scale.