High Performance Healthcare: Using the Power of Relationships to Achieve Quality, Efficiency and Resilience (MGMT & LEADERSHIP)

Highly useful book to improve understanding on how team work can have positive impact

The delivery of healthcare is a highly complex process that is considered an industry, from the business perspective; and a service, by many of the disciplines (medicine, nursing, allied health, etc. Healthcare delivery is highly complex and can only be addressed when we consider both the business and the service aspects simultaneously. Jody Hoffer-Gittell presents research on this complex process from the system perspective and addresses the structures (high performance work practices), the processes (relational coordination) and the outcomes (quality efficiency and satisfaction).Delivery of health care delivery is high stakes (in human and economic terms), and with changing demographics (guaranteed increase in people needing healthcare) and the ongoing economic changes, it is approaching a crisis state. Everyday we read commentary on the Affordable Care Act and opinions on future directions. Most of these opinions are emotional and political with little basis in science.Gittel's work is based on science and addresses all aspects of the healthcare (structure, processes & outcomes). I practice and teach nursing in a university and a large health system and study health care system change. We have few comprehensive models to assess and improve health care. Gittel's work can guide health care mangers (looking at the business side), practice leaders (looking at the service aspect) researchers/educators (expanding our knowledge), with a solid scientific framework. Using this model, we evaluate and improve our healthcare system, based on system science rather than emotion or politics. I recommend this book for all leaders trying to improve healthcare.

Excellent textbook regarding the challenges facing the healthcare industry. Unfortunately, my book arrived "backwards"...pages were bound in reverse order relative to the cover..Annoying....

I practice and teach medicine in a large university system and study and advocate for health care system change. It is all too easy, confronted by the numerous failings of health care in the US and the increasing attention to technological remedies such as the electronic health record and system redesign at the macro level like accountable care organizations (ACO's), to become overwhelmed and paralyzed. Hofer Gittel's book reminds us that, at their heart, systems are people and their relationships. Arrangements like ACO's are simply that, arrangements of people and functions, and EHR's are tools to facilitate the communication of information among people. Her clear exposition of the connection between the quality of relationships between health professionals and the outcomes they produce for their patients not only makes perfect sense, it points the way to improvements we clinicians can work towards right now - improvements in our working relationships that will be necessary regardless of the ultimate fate of the Affordable Care Act, the roll-out of health information technology nationally, and other matters of policy and politics that are beyond our individual control. The observations in this book about the correlations between the quality of working relationships between collaborative in complex endeavors doubtless generalize well beyond medicine - Hofer Gittel started with airlines after all - but health professionals should take this book to heart. What would your practice, your inpatient unit, your service look like if you and the others working there read this book together and applied its lessons?

I became aware of Professor Gittell from the groundbreaking work that she undertook in the airline industry. Her current focus on healthcare is a natural offshoot of that earlier work. As she points out again and again, the comparisons between the two industries are striking including "the complexity of the underlying work, the functional specialization and expertise required delivering high quality outcomes, the coordination challenges...the increasing cost pressures... and competing worker interests". Her analysis highlights the paradox that relational coordination is lowest for physicians in spite of their central role in delivering patient care; this paradox is not sustainable. Physicians must emerge as champions of relational coordination, working with enlightened senior leaders to implement a high performance work system as defined by Professor Gittell. The challenge, of course, is implementation.