May 03, 2018

10:00-11:00 a.m.

Please note: This event is for invited researchers only.

Exploring the Role of Leadership Facilitation on Primary Care Team Participation, Relational Coordination, and Group Solidarity

Talk description:
Team coordination is a central aspect of integrated care delivery and increasingly critical to primary care practices of Accountable Care Organizations (ACOs). While several studies demonstrate the positive relationship between relational coordination and performance outcomes, less is known about ways to foster relational coordination. We examine the association of leadership facilitation and relational coordination in primary care practices in ACO’s, and examine the role of team participation and solidarity culture in explaining the association. Pooled responses (N=764) at two points in time were obtained from Primary Care Practice (PCP) team members employed by 16 PCPs of two large ACOs. Using a two-level hierarchical structure with members clustered within practices, multilevel linear regression estimated the relationships among leadership facilitation, team participation, group solidarity, and relational coordination controlling for age, occupation, gender, team tenure, and team size. Leadership facilitation (0.18, p<0.001) and team participation (0.17, p<0.001) were positively associated with relational coordination, but solidarity culture was not associated. The association of leadership facilitation and relational coordination was only partially mediated by team participation but not solidarity culture, accounting for 15 percent of the relationship. Both leadership facilitation and team participation were positively associated with relational coordination in PCPs of the two ACOs. Group solidarity, however was not associated with relational coordination, indicating that solidarity may reflect in-group behavior or homophily that may not necessarily contribute to better team coordination. Relational coordination among primary care team members can be supported by enhancing leadership facilitation and/or by improving team participation as these independently support coordination.

Thomas Huber’s research focuses on positive and collaborative leadership and change management in healthcare organizations. He has led work in improving quality, safety, and patient experience in healthcare for more than twenty years in such areas as performance improvement, operational excellence, leadership and strategy. He has diverse professional leadership experience in industry, academia, and management consulting.

Huber’s research focuses on leadership at the individual, team, organizational, and societal levels. He is interested in understanding the role of positive and collaborative leadership in enabling and promoting positive deviance in quality, safety, and patient experience in organizations. He is a mixed methods health services and management researcher with an emphasis on innovative qualitative, ethnographic, and positive post-modern methods. In the past, Huber has led research and evidence based consulting engagements as a managing director of strategy at Kaiser Permanente leading large-scale change efforts across thirty-six hospitals, developing leadership improvement science capability in Silicon Valley companies, and leading multi-institutional research collaboratives.

Huber has worked with many clinics, hospitals and health systems across the United States and Europe including such organizations as; Kaiser Permanente, Bon Secours Health System, California Children’s Hospital Association, California Healthcare Foundation, Intermountain Healthcare, Mayo Clinics, and Mass General Hospital. Huber has been a research associate at Dartmouth Medical School and faculty member of the Institute for Healthcare Improvement. He has a doctorate in Health Policy and Management from the UC Berkeley, a master’s degree in public health from the Dartmouth Institute of Health Policy and Clinical Practice, and a bachelor’s degree in Philosophy and Psychology from Dartmouth College.

Research is the heart of Positive Organizational Scholarship (POS), and we want to make sure that we support each other in developing high quality research. To that end, we created the Adderley Positive Research Incubator for sharing and encouraging POS-related research ideas that are at various stages of development.

Learn more about the Adderley Positive Research Incubator here and direct questions about individual sessions to Amy Young at