The Social Basis of Collaboration

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The Social Basis of Collaboration
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• Thinking of stakeholders in existing
  categories is not especially useful
• Providers
• Policy makers
• Purchasers
• Patients
• Reflects, if not causes, the barriers to
  collaboration

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• Collaboration does not take place between
  abstract (and assumed homogeneous) categories
• Collaboration takes place between people

Must begin with understanding human social
interaction
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Overarching Principle Behavior is a function of
the meanings we attach to persons, objects and
events in our environment (our life space)
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Human Interaction
Patient makes a gesture (any act that has some
meaning)
Physician
Patient
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Human Interaction
Gesture has meaning to physician
Physician
Patient
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Human Interaction
Physician responds with a gesture that has some
meaning to patient
Physician
Patient
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Human Interaction
If the intended meaning is the perceived meaning
there is some level of effective communication
interaction
Physician
Patient
But far more than this!
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• Gesture to both self other
• We are both subject and object unto our selves
• We observe our behavior as we engage in it

Physician
Patient
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If my gesture calls out in me the same meaning it
calls out in you we have the beginning of
collaborative communication interaction.

Physician
Patient
If this is anticipated, I know before I act.
Collaborative interaction possible. Taking the
role of the other.
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• This is social behavior
• How social relationships form
• What determines conflict or collaboration

Physician
Patient
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Behavior is a function of the meanings we attach
to persons, objects and events in our environment
(our life space) The person, object, event that
is always in our life space is SELF
Identity (Who Am I?) is crucial to any form of
collaborative interaction
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Master Statuses dominate self create a
pervasive identity that traps us in a set of
non-reflective acts. CEO, Physician, Scientist
are Master Statuses
That often make it difficult to take the role of
the other. Cultural values of individualism,
responsibility, control
CEO
Physician
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Social Interaction is Transformational

• Identity (who am I?) is created continuously in
  social interaction. We are the responses of
  others to us.
• Self Social separation does not exist
• We are and become the social interactions we have
  and create. Get stuck in our Master Status
  created identities.interaction with those like
  us.no diversity

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Getting our foot out of the social mud of barrier
identities without pulling our shoe off

• Must always start with acts that call out in
  ourselves the same meaning they call out in those
  with whom we wish to form a collaborative
  relationship
• That can only begin by discovering what is deeply
  personally meaningful to people. Can never assume
  we know.
• What is it that you care deeply about?

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Creating Collaborative Interaction

• Do we care deeply about the same thing?
• How can we get there?
• Together develop all of the different scenarios,
  narratives, what ifs. Start with the present.
• To see feel different futures
• To see the consequences of different actions for
  what we all care about.
• Co - Created Vision
• Never install. Always Co-create
• Engagement, ownership, basis of new identities
• Installation reinforces existing barrier
  identities

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Creating Collaborative Interaction

• Let complexity work
• Forget a plan
• Let self-organizing and co-emergence occur
• Emergent forms only come from the interaction of
  difference and sameness
• Takes courage, tolerance of risk the unknown
• Building the bridge as you walk on it (Quinn)
• If we build the bridge for others they do not own
  it, will not be engaged, and will not walk on it

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Creating Collaborative Interaction

• This will naturally bring about
• Something you will only discover as it unfolds
• Something we could not plan upfront
• New concepts of self, new identities
• New forms of social relationships - collaborative
  
• Moving toward real teamwork. Measure it to
  maintain sustainability

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It is really all about Compassion
Compassion is the ability to feel with another
person, and even more basically, to be with
another in their situation, to be fully
present. Being a Citizen in Human Society The
social structural barriers to collaborative
interaction are the unanticipated consequences
of purposive social action in which good people
find themselves stuck often so stuck they do
not see they are.
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Team Development is Developmental
Fully Developed
88 - 100
All Team Attributes Firmly in Place
Goals, Means Established
Stage 8
81 - 87
Stage 7
78 - 80
Roles Established
Communication Established
Stage 6
70 - 77
Stage 5
64 - 69
Cohesiveness Established
Stage 4
58 - 63
Building Clarity of Goals, Means
Stage 3
55 - 57
Building Clarity of Roles
Stage 2
47 - 54
Building Communication
Stage 1
37 - 46
Building Cohesiveness
PreTeam
0 - 36
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Typical 1st Assessment Results
Pre-Team
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Cohesiveness

• What is it?
• Team members are attracted to the team
• Membership in the team is a personally meaningful
  experience
• Enjoy the company of the other team members
• Support, nurture, and care for each other
• Feel free to share ideas and suggest ways to
  improve team function
• Have a strong we feeling

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Cohesiveness

• Why Important?
• A team is a social, not an instrumental,
  phenomenon
• Cohesiveness is the social glue there will be
  plenty of bumps
• Team foundation relationships basis of
  collaboration

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Communication What is it?

• Team members freely say what they feel and think
• Communication between members is direct,
  truthful, respectful and positive
• The team openly discusses decisions before they
  are made
• Conflict is handled in a calm, caring and healing
  manner
• When problems arise the team openly explores
  options to solve them
• Team members do not have hidden personal agendas

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Communication Why Important?

• Drives all the teams behavior. The social.
• Teams are special - usual social interaction is
  highly ineffective nonproductive
• Sensemaking (attribution) must be guided It is
  will always take place. It must.
• Misattribution occurs when there is lack of
  clarity

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• Other Key Measures
• Engagement
• How engaged are the people
• How engaging is the culture
• How much teamness
• Activation
• It is developmental, thus first things first
• Responsibility Knowing something can be done
• Self-Efficacy (from experiencing small successes)
  
• Consistent action
• Staying the course under duress