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Transforming Relationships for High Performance The Power of Relational Coordination Jody Hoffer Gittell 319p B01I1HG5A PDF

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TRANSFORMING RELATIONSHIPS FOR HIGH PERFORMANCE The Power of Relational Coordination JODY HOFFER GITTELL STANFORD BUSINESS BOOKS An Imprint of Stanford University Press Stanford, California Stanford University Press Stanford, California © 2016 by the Board of Trustees of the Leland Stanford Junior University. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or in any information storage or retrieval system without the prior written permission of Stanford University Press. Special discounts for bulk quantities of Stanford Business Books are available to corporations, professional associations, and other organizations. For details and discount information, contact the special sales department of Stanford Univer- sity Press. Tel: (650) 736-1782, Fax: (650) 725-3457 Printed in the United States of America on acid-free, archival-quality paper Library of Congress Cataloging-in-Publication Data Names: Gittell, Jody Hoffer, author. Title: Transforming relationships for high performance: the power of relational coordination / )ody Hoffer Gittell. Description: Stanford, California: Stanford Business Books, an imprint of Stan- ford University Press, 2016. I Includes bibliographical references and index. Identifiers: LCCN 2015050233 I ISBN 9780804787017 (cloth: alk. paper) I ISBN 9780804797047 (electronic) Subjects: LCSH: Organizational change. I Interpersonal relations. I Organizational behavior. Classification: LCC HD58.8 .G575 2016 I DDC 658.4/06-<lc23 LC record available at http://lccn.loc.gov/2015050233 Typeset by Newgen in 10.5/ 15 Minion CONTENTS Preface VII Acknowledgments ix PART ONE RELATIONSHIPS AND PERFORMANCE 1 Chapter 1 Meeting Performance Pressures with a Relational Response 3 Chapter 2 How Relational Coordination Drives High Performance 13 Chapter 3 Engaging Clients in Relational Coproduction 31 Chapter 4 Engaging Co-Workers in Relational Leadership 45 Chapter 5 How Structures Support-or Undermine- the Three Relational Dynamics 60 PART TWO GETTING FROM HERE TO THERE 77 Chapter 6 A Relational Model of Organizational Change 79 Chapter 7 Relational Coordination at Group Health 95 Chapter 8 Relational Coproduction in Yarde Municipality 118 Chapter 9 Relational Leadership at Dartmouth-Hitchcock 144 Chapter 10 Bringing It All Together at Billings Clinic 170 v i CONTENTS PART THREE TOOLS FOR CHANGE 197 Chapter 11 Relational Interventions to Create New Ways of Relating 199 Chapter 12 Work Process Interventions to Create New Ways of Working 221 Chapter l3 Structural Interventions to Support and Sustain the New Dynamics 243 Chapter 14 Bringing It All Together in Your Organization- and Beyond 265 Notes 277 Index 299 PREFACE As I began to observe organizational change in real time, I found many sur- prises. For example, I realized that something needs to happen for people to have different, more productive conversations, to be able to get past the bar- riers of "you're in this role and I'm in this role, and I can't say what I think," and open up that path of communication to create new relational dynamics. Another surprise was seeing people take the network measure of relational co- ordination that I had invented as a research tool and use it instead as a mirror to provide feedback and to notice "Oh, look, this isn't good communication between us and this other group. We thought it was, but it wasn't." It was as if they were using the measure as a boundary object, observing together what was going on, then giving themselves and each other permission to communi- cate and relate in different ways. The cases presented in this book demonstrate the Relational Model of Or- ganizational Change in action; they show that transformed relationships are at the heart of sustainable positive change. This model took shape in early 2011, when Ed Schein invited Amy Edmondson and me to regular meetings in his living room overlooking the Charles River and the Boston Museum of Science. Over the course of several months, he demonstrated what it means to create a relational space-a space in which it is safe to admit what you don't know and to learn from others-not so easily accomplished among academics, who tend to have a fair amount of ego! My major insight from these conversa- tions was that organizational change does not start with the adoption of new structures, as my previous work had argued. Rather, it starts with participants changing their patterns of relationships just as they change the way they do viii PREFACE the work. Structures cannot be overlooked-indeed, they are essential for sup- porting and sustaining those new patterns. But by themselves they cannot cre- ate those new patterns. Sustainable change is likely to require relational and work process interventions, accompanied by structural interventions. These conversations prompted me to observe change agents in action and helped me to notice new things. In this book, you will meet change agents-such as Tony Suchman, Marjorie Godfrey, Curt Lindberg, Carsten Hornstrup, Diane Rawlins, Kim DeMacedo, and their colleagues and clients-who turned the Relational Model of Organi- zational Change into a living, breathing reality. You will see how theory meets reality and helps to transform it, and vice versa: how reality meets theory and helps to transform it. Our journey takes place amid tremendous performance pressures we are facing in our world today-pressures that require a relational response. ACKNOWLEDGMENTS Transforming Relationships for High Performance would not have been pos- sible without the generosity and openness of many change agents in many organizations-especially Group Health, Varde Municipality, Dartmouth- Hitchcock, and Billings Clinic. There were others as well. In 2011, a series of influential individuals, most of whom I had not known before, approached me one by one with the idea that relational coordination could provide practi- cal insights for organizational change. They included Tony Suchman of Rela- tionship Centered Health Care; Dale Collins Vidal and Marjorie Godfrey of Dartmouth-Hitchcock; Ken Milne, Nancy Whitelaw, and Margaret Nish of Sa- lus Global; Thomas Huber of Kaiser Permanente; Gene Beyt of Indiana Uni- versity Health; Kathryn McDonald of Stanford Health Policy; and Deborah Ancona, John Carroll, and Edgar Schein of MIT Sloan School of Management. I thank these individuals for inspiring me to establish the Relational Co- ordination Research Collaborative, an international network of scholars and practitioners headquartered in the Heller School of Brandeis University, and for serving in many cases as its original board members. I thank the colleagues who have staffed the Collaborative with me-Joanne Beswick, Megan Cun- niff, Debbie DeWolfe, and Lynn Garvin-and those who have led the spin-off we created to better serve clients around the world-Saleem a Moore, Michael Noce, and Stan Wallack of Relational Coordination Analytics. As always, I thank my family for providing me with inspiration and sup- port throughout the long process of researching and writing this book. In this book, more than my previous ones, they have contributed their insights as well. Ross Gittell provides a macroperspective through his work on building x ACKNOWLEDGMENTS human capital and social capital for economic development. Our youngest, Grace Hoffer Gittell, provides a microperspective, with her reflections on cre- ating change through personal example. Our oldest, Rose Hoffer Gittell, links micro and macro relational patterns through her study of neuroscience and macroeconomics. My parents, John and Shirley Hoffer, have role modeled re- lational coordination in their daily lives ever since I can remember. All of their perspectives have informed this book, particularly the concluding chapter. Now I invite you to read on, to become inspired by the many change agents you will meet, and to inform your own journey of creating positive relational change. TRANSFORMING RELATIONSHIPS FOR HIGH PERFORMANCE

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