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Open Access Highly Accessed Research article

A model and typology of collaboration between professionals in healthcare organizations

Danielle D'Amour1*, Lise Goulet2, Jean-François Labadie3, Leticia San Martín-Rodriguez4 and Raynald Pineault5

Author Affiliations

1 Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada

2 Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada

3 Centre de santé et de services sociaux de Bordeaux-Cartierville-Saint-Laurent, Quebec, Canada

4 University Hospital of Navarra, University of Navarra, Pamplona, Spain

5 Public Health Directorate, Montreal, Quebec, Canada

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BMC Health Services Research 2008, 8:188  doi:10.1186/1472-6963-8-188

Published: 21 September 2008

Abstract

Background

The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec. The objectives are to: 1) validate the indicators of the structuration model of collaboration; 2) evaluate interprofessional and interorganizational collaboration in four health regions; and 3) propose a typology of collaboration

Methods

A multiple-case research strategy was used. The cases were the healthcare facilities that offer perinatal services in four health regions in the province of Quebec (Canada). The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions. Written material was also analyzed. The data were subjected to a "mixed" inductive-deductive analysis conducted in two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases.

Results

The collaboration indicators were shown to be valid, although some changes were made to three of them. Analysis of the data showed great variation in the level of collaboration between the cases and on each dimension. The results suggest a three-level typology of collaboration based on the ten indicators: active collaboration, developing collaboration and potential collaboration.

Conclusion

The model and the typology make it possible to analyze collaboration and identify areas for improvement. Researchers can use the indicators to determine the intensity of collaboration and link it to clinical outcomes. Professionals and administrators can use the model to perform a diagnostic of collaboration and implement interventions to intensify it.