Study: In interorganizational health care collaborations, stability of representation is key

Interorganizational collaborations are increasingly used to tackle some of society’s most complex challenges. In health care, this takes many forms, such as strategic alliances, interorganizational networks, joint ventures, and public-private partnerships. The effectiveness of these collaborations hinges on participants pooling expertise toward the joint goal, but also on whether participants leverage each other’s expertise for their own organizations’ independent goals. The spillover of progress on those independent goals can sustain participation in the collaboration itself.

In a new study, researchers sought to gain a more thorough understanding of how participants of interorganizational collaborations can identify expertise that could be leveraged toward their organizations’ independent goals. Their findings, highlighting the importance of stability of the people involved (not just stability of the participating organizations), can inform the work of interorganizational health care alliances.

Conducted by researchers at Carnegie Mellon University and Santa Clara University, the study is published in Health Care Management Review.

“Despite the potential benefits of participation in interorganizational collaborations, research continues to show the difficulty of sustaining participants’ engagement, something that seems to improve when participants are getting a sort of spillover effect so they learn something relevant for their own organizational needs along the way,” notes Anna T. Mayo, assistant professor of organizational behavior at Carnegie Mellon’s Heinz College, who coauthored the study.

“That means the spillover is not just beneficial for independent goals. By sustaining engagement, it increases the effectiveness of the joint effort. Nevertheless, that spillover is often limited, and we wanted to better understand why.”

In their study, researchers examined the workings of a successful U.S. interorganizational health care alliance whose goal was to empower and accelerate the growth of leading clinical centers in their specialty. They conducted and analyzed interviews with 21 individuals involved in the alliance and triangulated their findings by analyzing seven years of the alliance’s records (e.g., meeting minutes).

Study findings suggest that the expertise that was available for one organization to leverage toward an independent goal was often hidden because it was not pertinent to the alliance’s joint goal. They found that relevant expertise was not merely a matter of participants paying attention to both the joint goal and their own independent goals—what would typically be recommended—but also to the other organizations independent goals and related expertise. Several key mechanisms emerged as likely to support that attention and ultimate leveraging: stability in alliance representatives (i.e., not the participating organizations, but the people representing them), interpersonal relationships, and formal mechanisms that guided attention to others’ independent goals like report-outs during a meeting.

“To the extent that the focus was on stability up to this point, it was on the stability of the participating organization,” explains Esther Sacket, assistant professor of management at Santa Clara University’s Leavey School of Business, who coauthored the study. “But this can breed a false sense of stability. Stable participation at the organizational level does not mean that the people involved in the collaboration are stable. Because of the interpersonal relationships formed, representatives from a particular organization are not interchangeable, and members of alliances should consider assigning a core person or group of people from their organization to participate consistently in the collaborative’s work. But if representative stability cannot be preserved, the loss of information might be mitigated by intraorganizational handoffs along with systems to keep track of expertise and goals, such as dashboards or repositories.”

Among the limitations of the study, the authors note the small sample and a need for additional work that could explore causal effects and test the utility of practices designed to bolster leveraging behavior.