Maintaining authentic relationships for cross-organisational working

Collaboration in health care can drive innovation, improve patient outcomes, and optimise resources. But despite its potential, many collaborative projects fall short due to lack of clarity, misaligned expectations or poor communication. 

Reflecting on my own journey, I have experienced varied success with collaborative working. Some collaborations have ended within a few months while others have been highly successful in achieving our collective shared goal. 

Here’s some of what I’ve learned on my journey as part of Q Lab and Q Exchange. Coaching calls provided throughout these programmes have offered me invaluable opportunities for continuous reflection and personal growth. 

These experiences have not only deepened my understanding of collaboration but enabled me to extract key learnings that have shaped my approach to both research and collaboration. 

In health care settings, stakeholders will have a range of motivations for taking part in collaborations. This can affect how they engage with the shared work. 

Recognising and addressing these motivations early on is key to building trust and ensuring that all contributions are meaningfully aligned with the collective goal. 

Being upfront about what you are hoping the stakeholder can bring to the project and how they can support the collaborative journey fosters transparency and trust. 

Through these discussions, you can identify potential conflicts or misalignments at the outset, allowing teams to address them before they escalate. 

The first step in any collaborative working is ensuring that all stakeholders are both aligned and interested in the work and its outcomes. 

In one project I was involved with, as it progressed, it became apparent that some of the team’s focus differed from the original collective goal. Individual priorities began to outweigh shared goals, ultimately affecting collaboration and the project’s progress. 

Without a clear mission, team members might unintentionally move in different directions, leading to confusion, wasted effort, or even conflict. There is also a risk of scope creep, which can result in increased project requirements over time. 

When a mission is clearly defined, it provides a common purpose and direction. Carefully monitoring and addressing scope creep will ensure that only necessary changes are allowed. 

As well as having a shared goal, having clearly defined roles helps drive progress by creating accountability, reducing duplication and enabling more cohesive teamwork. 

In the previous scenario, more clearly defined roles would have made it easier to spot the deviation from the project’s mission. Everyone would have understood who was responsible for what, and where the boundaries of personal priorities ended and the shared project goals began. 

When stakeholders understand what they’re bringing to the table and what they can expect in return, the chances of collaboration success increase exponentially. Defining roles early helps ensure that everyone’s efforts contribute to the common goal. 

Unresolved ambiguity can be one of the biggest threats to effective collaboration. In health care projects where the stakes are high, even small misunderstandings can lead to larger issues down the line. 

In one project I worked on, a lack of clarity around timelines led to initial delays because some stakeholders thought the deadline was flexible, while others felt it was non-negotiable. 

This misalignment wasn’t due to a lack of commitment but differing assumptions and interpretations. This highlighted how important it is to check for shared understanding, not just agreement. 

Identifying and addressing this at an early stage helped all stakeholders to work to the same timeline, enabling us to meet deadlines with good outcomes. 

Ambiguity can also arise when words or concepts have multiple meanings or interpretations, which can lead to confusion or errors. This is especially true in interdisciplinary or multicultural settings. 

Some of the tools and practices we used in our cross-organisation collaboratives helped us to address ambiguity. For example, establishing standardised terminology and using clear and precise definitions of terms up front helped us avoid misunderstandings. 

Additionally, shared language helped us to recognise the importance of context. A common language acknowledges ambiguity and encourages clarifying questions or further explanations if a term could be interpreted in more than one way. 

Visual aids were another tool used in our project to bridge gaps in verbal or written communication. Diagrams, charts, or creative art helped to clarify complex concepts or ambiguous ideas. 

Finally, encouraging feedback within a common language helps ensure that all parties have understood each other accurately. 

When collaboration and integrity are both prioritised, they create a synergistic relationship. This is underpinned by: 

• Trust and collaboration: Collaboration thrives on trust, and trust is built through integrity. When integrity is present, all members can be confident in each other’s intentions and contributions. 
• Shared accountability: A collaborative team works more productively and efficiently when all members hold each other accountable, ensuring they follow through on their commitments. 
• Long-term success: While successful collaboration often leads to immediate outcomes, integrity ensures that the results are sustainable. A culture of fairness, respect and consistency builds stronger relationships within the team, leading to long-term success. 
• Conflict resolution with integrity: When conflicts arise, rather than resorting to blame or manipulation, seek mutually beneficial solutions. This strengthens the collaboration in the process. 

Successful collaboration and integrity go hand-in-hand in creating environments where teams can work effectively, share ideas, overcome challenges, and produce meaningful outcomes. 

Integrity acts as the ethical backbone of collaboration, while collaboration maximises the potential of individuals working together. 

Collaboration doesn’t end once the roles are defined or after initial meetings. Regular check-ins and follow-up meetings are vital to ensure that the project stays on track, milestones are achieved, roles are being respected, and that no one is deviating from the mission. 

As well as helping to address miscommunication, they enable expansion or adjustment of plans, foster discussions around shared goals, improve team work and maintain authentic relationships. 

When it comes to health care collaborations, like any complex human system, clarity is a key. 

The Pathway to Equity project is an example where authentic relationships and acting with integrity helped to amplify our mission. 

This project started with a small group of 20 like-minded and dedicated health care professionals and young people with a shared passion to address health inequality. It has now grown to over 50 colleagues from across the health care and education sectors, working collaboratively to improve the lives of young people in our local community. 

A successful collaboration requires a shared vision, mutual respect, clear expectations and the willingness to address issues before they escalate.