High Performance Healthcare: Using the Power of Relationships to Achieve Quality, Efficiency and Resilience

According to Jody Gittell, improving the quality of healthcare while reducing the cost is not rocket science but neither is it easy. Healthcare involves a number of different disciplines that must work together. These different disciplines are the physicians, nurses, physical therapists, case managers, social workers, clinical and administrative staff. Often the different disciplines are not working together toward a common goal, do not share knowledge or enjoy mutual respect. Ms. Gittell uses her experience from her studies of the airline industry to draw some parallels to the healthcare industry. In the airline industry, Southwest Airlines stands head and shoulders apart from other airlines. She cites their operational and relationship differences as being the basis for the superior performance. In her opinion, there are many similar characteristics - that is both involve many different disciplines working together in a highly interdependent environment. The premise of the book is that by improving relational coordination in the health care industry, it is possible to improve the quality of healthcare and reduce the cost. The core of the book centers around studies of relational coordination involving a number of different hospitals and the results obtain from these studies. While the studies found that by getting the different disciplines to operate with shared goals, shared knowledge and mutual respect, because of long standing traditions in the healthcare industry the implementation of relational coordination can be a bit tricky. The theory seems sound. The implementation will certainly be very difficult. One of the major problems is the physician has always taken the position that they were independent and have operated as such. Changing these entrenched behaviors will be difficult. It is an interesting study and advances a lot of sensible ideas. However getting all the diverse disciplines to buy-in will be a huge task. The major benefit of the ideas advanced in this book will be hospitals. It has some limited applications to the physicians office.