Increasing Performance with More Effective Coordination

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Increasing Performance with More Effective
Coordination
Farbod N. Hagigi, MPH, Ph.D. Candidate
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Research Question

• Can organizations increase their
• performance by improving coordination?

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Coordination

• Managing dependencies between activities (Malone
  and Crowston 1994)
• Two views
• Information processing (Galbraith 1972 Tushman
  1978 Argote 1982 March Simon 1958)
• Relational (Gittell 2002 2003 2004 2005
  Faraj 2006)

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Coordination

• Importance in health care
• Fragmented providers and facilities
• Difficult because of complexities of service
• Poor coordination results in (IOM 2001 Miranda
  2002 Halm 2003 Gittell 2000, 2005 Young 1998
  Strauss 1989)
• Low quality and efficiency
• Errors in medication and treatment
• Conflicting information

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Coordination Performance

• Increased performance (Granovetter 1985 Uzzi
  1996)
• Trust
• Fine-grained information transfer
• Facilitate problem solving arrangements
• Mitigating cost/quality tradeoff with improved
  management practices

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Model
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Study Site

• 16 primary care clinics
• 3 hospitals
• Complex patient population
• Decentralized management of clinics
• EMR implementation

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Data

• Coordination Data
• Coordination surveys (Gittell Weinberg)
• Interviews
• Performance Data
• Quality
• Costs
• Risk adjustment demographic and health

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Coordination Performance
Chilingerian 2004
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Coordination Performance
Schmenner 1998
Chilingerian 2004
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Broader Goals

• Understanding relative importance of underlying
  factors that impact performance, focusing on
  coordination as a key factor
• Using novel methodologies for performance
  measurement
• Theoretical contributions to coordination
  literature

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