Collaboration in Healthcare Using Appreciative Inquiry – PS113

Collaboration in Healthcare - aged couple in nature
Photographer: Jaddy Liu | Source: Unsplash

Wendy Gain’s story of appreciative leading is about her work brokering partnerships and building collaboration in healthcare. She brings disparate groups together so they begin to trust each other, and c0-create visions for an agreed pathway forward.

At the beginning of our conversation, Wendy respectfully acknowledges the traditional custodians of the land on which she is sitting, the land of the Quandamooka People.

Turning Point in Career

Collaboration in Healthcare - Wendy Gain
Wendy Gain

Wendy has a background in healthcare and in leadership and management across government agencies and service providers and a range of different community sectors in Australia. Wendy has invested in all kinds of professional development, in the health and business arenas, in human and organization development; and today her professional focus is on brokering partnerships and building collaborations in healthcare. She facilitates this work across a range of groups throughout Australia.

In 1997, Wendy was part of a rescue team called in to help in the recovery following a landslide in one of Australia's popular ski resorts, Thredbo. When the disaster hit around midnight, nineteen people were trapped in the rubble in their ski lodge in the side of the mountain. On the fourth day, the sole survivor was rescued. Until that sole survivor had been found, Wendy had spent time with the families talking to them about the chances of finding anybody alive as extremely negligible. When that one person was found still alive, it came down to only one family where there was still hope of a survival.

It was about the understanding of the importance of hope. Positive hope can enable you to go forward. I have always connected with the positivity of hope. When you've got hope, you've got something.

Hope as a Positive Force for Change

Wendy's experience at Thredbo strengthened her belief in the power of hope as a positive force for change. She sees it essential in the role of leadership.

Wendy: Appreciative leadership brings with it a level of responsibility in that you're looking to lead people in a positive direction, and to help them find that they can move from where they are into something different. One of my colleagues has a tattoo on his arm which states: be calm and be full of hope. For us therapy types, when we've been super busy and we're trying to get things done that tattoo on his arm is ever present.

It's also the most particularly delightful reminder that there is always the opportunity for hope. It has such a positive connection for me. It always means that there's a positive way forward and I'm always committed to being able to find that positive way to move forward. So as a leader, if you find yourselves in a situation where you don't know what to do and you're stacking the dead in the water and nothing's happening for you, let me help you navigate your way forward. Let me help you find a way to make this better for you.

Partnerships and Collaboration in Healthcare

Much of the work that Wendy does is to help connect Aged Care and Palliative Care to improve the quality of care for the aging. While the different providers talk of “partnerships” and “collaborations,” she finds that the term “partnership” is mostly not appreciated in its fullest form.

Wendy: Partnership is a word that is used way too frequently and inappropriately. So when you talk about a partnership, it's about an ongoing relationships where the risks and the benefits are going to be shared across those that are in the partnership. There are a lot of people who use the “partner” in the partnership word without that meaning. They just say, well, I'll just partner with you and we'll go over here and do this, but there's no intent to be able to share the risks and the benefits.

So for me, whenever people say, we'd like you to come and work with us to be able to develop a partnership, I say that we need to be really clear about what a partnership is. Part of that work is bringing people along to understand what is the partnership and then what are those principles which must be present in order for a partnership to not only form but to flourish.

Unpacking the Differences to Make the Difference

Collaboration in Healthcare - Dawn dusk
Photographer: Todd Diemer | Source: Unsplash

Wendy: In my work across the Aged Care in Palliative Care you're working with the workforce where Palliative Care health professionals have all got university degrees. They've all been trained and they've got some experience. Whereas, in the Aged Care workforce, they don't necessarily have any health background. There's no requirement for the people who work in Aged Care to have any Health background. They can do some level of training, but it's not regulated.

So the levels of understanding across the Aged Care workforce and then across the Palliative Care workforce are quite different. You need to find some common ground and be able to unpack that meaning of partnership and collaboration; and how to work together to be able to improve the care of the older people that they're attending to.

It Happens through Conversation

Wendy: It's always in conversation. You can never talk enough to help people to understand, but you also need to take on board the principles of health literacy. Within Australia that's been a growing movement over the last five to ten years. So if you're working with a group of people whose educational attainment level is grade 9 or 10 in Australia and the piece of writing, or the brochure, or the workbook that you're sharing with them is based at a university level, you'll know that you'll have trouble getting a common level of language and understanding across the people that are meant to be sharing that workbook.

Health Literacy is incredibly important and it's not about dumbing something down. It's about making your language clear and concise and understandable. There's a whole range of readability tools that sit across the web that you can download for free. If you take something that you've written, or a document, or piece of work that you want to be able to share with other people and you apply a readability test to it, you'll be able to see where that piece of work is actually aimed.

Appreciative Inquiry to Move Forward

Collaboration in Healthcare - seated conversation

I invite Wendy to talk about how she applies Appreciative Inquiry in framing the conversations and to build the partnerships and strengthen collaborations in healthcare. I was particularly interested to hear how people found common values and aspirations for their collective work, irrespective of the educational and reading levels.

Wendy: I have found that Appreciative Inquiry is particularly useful in situations where the people that formed that partnership have a really difficult history; or they've all experienced something negative across them; or, if it is one of the barriers that are stopping them from actually forming a cohesive collaboration to move forward.

Listen in to the episode to hear a number of stories how Wendy has helped communities move forward from particularly difficult histories with the process of Appreciative Inquiry. Storytelling as a way to pull forward the positive from the past to envision more positive future. One example she cites:

The energy in the room went from this is too hard, and we can't do this; it's not that we don't want to, but we just can't. It went from that feeling to their feeling positive and lucky. You can feel the energy building in the room and once the energy filled us, we just kept going and getting stronger. One of the most fantastic things was that this particular organization had just put into the floor of the facility, the Totem of the local people. They could actually align their vision statement with that actual Totem's. What they developed was in line with their Totem.

Growing Compassionate Communities

An area of focus in the Aged Care communities is to strengthen death literacy.

Wendy: It's about being able to talk about death and dying in the open without having to hide it and not having to use words like “passed away” or “no longer with us.” It's about being quite open and honest about people die; and being able to help prepare people for death. It's also about being able to live in a community where people feel comfortable to have that conversation but also to understand what they, as community members could do to enable that person who is dying to be able to stay at home if that is what they want.

Compassionate Communities align really well with Palliative Care and also align with the Public Health Palliative Care Movement across the world being able to connect communities to understand the role that they can play in being able to help people to have the conversations about death and dieing. So it's about being able to talk about death, and also to understand how they can contribute and support.

Appreciative Leading – the Opportunity for Change

I offered Wendy one to three wishes for how those of us role leading others might be more appreciative.

Wendy: For me, it's the importance of challenging all of your assumptions. Because we come to things thinking: “oh, that's like that because of this.” You need to challenge your assumptions because it's in challenging assumptions you see opportunity for change. If you miss the opportunity to really understand, or to say: “you know what, I don't understand this. I really need to understand it better,” you can go off in a totally inappropriate direction. Yes, I'd say challenge your assumptions.

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