The pursuit of purposeful partnerships-making a health matrix successful

Objective: To analyse a matrix model of management to optimize the partnerships, collaboration and interaction between vertical management structures (services and geographical clusters) and horizontal clinical structures (Clinical Networks and Streams) in a large Local Health District [LHD] in New South Wales, Australia.

Approach: An ‘Action Research’ approach utilising a maturity tool, the Collaboration Rubric®, an evidence-based model for Network analysis. The rubric describes four types of collaboration and defines the three essential drivers that allow successful collaborations.

Outcomes: Benchmarking comparisons indicate that this LHD is operating at a level well above base level for the three drivers that enable collaboration [capacity, authority and shared value]. The professional relationship between Clinical Networks/ Streams and Operational Managers, is the main barrier to improving collaboration. The Operational Managers have clear positional authority related to the organisational structure and are accountable to their Executive for good governance and financial management. Clinical leaders hold substantial influential power derived from their professional authority.

The following actions have been identified to improve collaboration.

• Ensure all leaders actively “manage for collaboration“

• Executive fosters joint innovation projects characterised by collaborative practice between the Clinical Networks/Streams and Operational Managers.

• Ensure leadership accountabilities are held as close as possible to any projects (locally) involving reform or innovation

• Clinical Network/Streams’ operational plans are jointly agreed with local management and signed off by Executive

• LHD recruit leadership with skills in managing for collaboration

Conclusions: This evaluation supports the use an Action Research approach using the Collaboration Rubric® as a useful tool to define not only the type of collaboration required but the key drivers that must be addressed to facilitate improved [horizontal and vertical] partnerships leading to better outcomes. This local health district will build improved collaboration utilising the insights gained from this analysis.