Developing Relational Coordination: A Qualitative Study of Outpatient Mental Health Teams

Abstract

Previous studies have shown Relational Coordination improves team functioning in healthcare settings. The aim of this study was to examine the relational factors needed to support team functioning in outpatient mental health care teams with low staffing ratios. We interviewed interdisciplinary mental health teams that had achieved high team functioning despite low staffing ratios in U.S. Department of Veterans Affairs medical centers. We conducted qualitative interviews with 21 interdisciplinary team members across three teams within two medical centers. We used directed content analysis to code the transcripts with a priori codes based on the Relational Coordination dimensions, while also being attentive to emergent themes. We found that all seven dimensions of Relational Coordination were relevant to improved team functioning: frequent communication, timely communication, accurate communication, problem-solving communication, shared goals, shared knowledge, and mutual respect. Participants also described these dimensions as reciprocal processes that influenced each other. In conclusion, relational Coordination dimensions can play pivotal roles in improving team functioning both individually and in combination. Communication dimensions were a catalyst for developing relationship dimensions; once relationships were developed, there was a mutually reinforcing cycle between communication and relationship dimensions. Our results suggest that establishing high-functioning mental health care teams, even in low-staffed settings, requires encouraging frequent communication within teams. Moreover, attention should be given to ensuring appropriate representation of disciplines among leadership and defining roles of team members when teams are formed.

Relational Coordination at the Primary–Secondary Care Interface: Insights from a Cross-Sectional Survey in the South Tyrolean Healthcare System

“…In healthcare settings, such as SABES-ASAA, where the complexity of patient care often requires seamless collaboration across specialties and functions [21], the importance of RC cannot be overstated. Effective RC not only enhances the immediate working environment by improving communication and teamwork but also has a significant impact on patient outcomes, staff satisfaction, and the overall efficiency of healthcare delivery [22,23]. Weaknesses in RC can lead to fragmented care, inefficiencies, increased staff stress, and potentially higher turnover rates [24].…”

Belbin’s Team Role Balance and Team Effectiveness in Community Mental Health Teams in an Area of Northwest Ireland: Implications for Leadership

“…In addition, relatively high caseloads and multiple demands from external constituents differentiate CMHTs from other general multi-professional teams. Furthermore, competing pressures and priorities that CMHTs face, e.g., a chronic lack of resources and competing interests around prioritizing needs, make the work of CMHTs more demanding [4]. Finally, the management and leadership of CMHTs is more challenging and difficult because CMHTs are typically more diversely multi-professional compared to general health teams [5].…”