A striking aspect of health care is the resistance to collaboration. Yet getting support from others is an excellent way to jump-start an improvement effort. Whether or not a team is having difficulty getting started, members should consider looking outside the organization for colleagues and resources.
- Find another organization in the community (health care, senior care, advocacy, public education) interested or invested in improving end-of-life care, and investigate the idea of working together. Collaboration at this level increases the chances that improvement efforts will have widespread effect.
- Use an e-mail listserv or bulletin board on the Web to connect with others around the work and to find new ideas or answers to tough questions - or just to know that many others are involved in similar efforts.
- Attend national or regional meetings of organizations working on improving end-of-life care. Team members may be surprised by the number of colleagues nationwide who care about and struggle with similar problems.
- Invite an expert to visit the organization, to give grand rounds, or to meet with the team. New ideas are usually welcome - and the credibility offered by a national expert can raise awareness of the importance of the team's work.
- Visit another organization that is known for its outstanding end-of-life care. If a personal visit is impossible, talk to staff at the organization about their work: Find out about their successes, barriers and how they were overcome, other approaches to universal concerns. Visits and talks can be inspiring and can build confidence that better practice is possible. The team members can gather detailed information about the “how to's” from peers in other organizations - physician to physician, nurse to nurse, social worker to social worker. Such exchanges can provide a focus for improvement work and can stimulate creative thinking about adapting others’ ideas and strategies to improve care elsewhere.
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