The need for partnerships between health care professionals within geographical communities is increasing as new health care needs, trends, and issues arise. Nurses are vital contributors to these alliances and partnerships. According to Daiski (2004), nurses are recognizing the value of collaboration both within the nursing profession and with other health care professionals and community leaders. Successful collaborative efforts include networking, leadership, and vision. These behaviors enable providers to address a greater number of ideas and issues with fewer resources. As Wagner (2004) notes, concerted and synchronized interactions from multiple individuals and disciplines are needed to facilitate effective health care.

This article presents three elements, specifically networking, leadership, and vision, which are identified in the literature as necessary for the development of successful collaborative efforts. Examples of collaborative efforts encountered by two nursing leaders, the authors of this article, are used to show how networking, leadership, and visioning increase the effectiveness of community partnerships.

Definitions

In 1992, Grohar-Murray and DiCroce described collaboration as "a current buzz word and one that can be applied to relationships between practicing nurses and several other groups" (p. 293). This description holds true today. More recently, Chitty (2001) has defined collaboration as the process of toiling directly with other individuals in an attitude of teamwork that benefits the organization, individuals, and health care consumers. In other words, collaboration is the integral working of like-minded people toward a common goal. The Merriam-Webster Online Dictionary (2004) describes collaboration and related terms as follows:

• Collaboration is perceived as working together toward a common goal
• Partnerships are seen as a state or condition of associating or participating with others regularly regarding a joint interest
• Teamwork is the process of coordination of efforts to use the collective efficiency of a group of individuals to be successful at a task or focus of attention

Overall these terms reflect the idea of individuals coming together for a mutually accepted goal or mission.

Characteristics of Successful Collaboration and Partnerships

Based on the collaboration and partnership literature, we have identified three key behaviors that enhance the work of collaborative partnerships. Our experiences, too, have shown that these behaviors facilitate collaboration. These behaviors include networking, leadership, and visioning. Each of these behaviors will be discussed in turn. Following these discussions, we will illustrate how these behaviors have strengthened a variety of community partnerships in which we have been engaged. As we examined our experiences, we noted that networking was the most crucial element in each of these partnerships. Although the other two behaviors, leadership and visioning, were very important, networking consistently stood out as the most significant contributor to our success.

Networking

Collaborative efforts are strengthened by networking, which enables one to draw upon multiple resources and build a team to accomplish the desired objectives. An important networking skill is the ability to identify the resources that are available within the community. These resources include both financial resources and human resources. Lavoie-Tremblay (2004) noted that successful projects involve financial, cognitive, and human support and commitment from a variety of colleagues and superiors.

Putting multiple resources together requires networking skills. Kerfoot (2002a) has observed that the development of a complementary and synergistic group of individuals is imperative to the success of collaborative efforts. Buonocore (2004) stated that "effective leaders know how to surround themselves with the right people as resources" (p. 3). It is often necessary to look outside of one’s normal networks to find the right individual(s) for a given partnership. When an idea is developed appropriately, multiple individuals are frequently eager to become involved with the venture. It takes a community of individuals all working together to be successful. The development and maintenance of effective working teams is fundamental to advancing the successfulness of community endeavors (Institute of Medicine, 2001).

Leadership.

Another necessary element of collaborative partnerships is that of good leadership. The credibility of the leader is paramount to the success of the venture; leadership entails inspiring stakeholders to devote energy, time, and resources toward a positive endeavor (Buonocore, 2004). Leaders need to be able to transform practice cultures to achieve the desired outcomes (Wesorick, 2002). Kerfoot (2001) has gone so far as to suggest that successful leaders will motivate the group to achieve outcomes that exceed the prospects of the endeavor. Leaders must take the time to investigate the issues and become knowledgeable about the possible opportunities for success to occur. They need to remain visible, enthusiastic, and actively involved with the goals of the organization for the outcomes to be successful (Wagner, 2004). Outhwaite (2003) noted that leaders need to be willing to persevere and to take risks as they develop new opportunities for addressing the challenges identified by key stakeholders. However, leaders also need to be able to trust the group members. Schaefer (2004) wrote that a leader identifies the responsibilities for the different individuals involved in the program but then needs to get out of the way and let them do the jobs assigned. The reputations of the members of the group also play an enormous part in the success of the project. Laying of a sound foundation of leadership and membership for the collaborative efforts can be time-consuming, but in the long run is invaluable to the success of the venture.

Vision

The success of a collaborative project requires that everyone on the team be actively captivated by the mission and/or goals of the group. The Institute of Medicine (2001) noted the importance of a system’s identifying its shared purpose; this allows for a core set of principles to be developed to guide the innovation or partnership. Cooper (2003) concluded, "…leadership is therefore about influence, but it is also about inspiration – those with the inspiration to inspire belief in ourselves" (p. 2). Kerfoot (2002b) stated "inspirational leaders instill an intrinsic drive that is fueled by a higher purpose, a sense of mission, and a commitment to a vast array of possibilities" (p. 2 ), and added that inspired individuals engage a "fire of passion" for the vision of the project that results in an inherently and independently driven success for the endeavor.

Vision comes from the leader. Without the leader taking the initiative to excite the committee, the efforts of the group frequently become fragmented and ineffective. A shared vision held by all partners is an essential early step in the partnering process. According to Schaefer (2004), "…worthwhile work involves understanding the work and knowing how the work helps others" (p. 2). Once steadfastness to the goal is developed, the enthusiasm for the consortium seems to fall into place.

Examples of Collaborative Efforts and Partnerships

The following are examples of partnerships and collaborative efforts in which the authors have participated during the past six years. These examples will illustrate the ways in which networking, leadership, and vision have worked to enhance the success of the initiative.

Getting started with a collaborative project can be as simple as two interested parties discussing mutual research interests. Such was the case when two Regional Deans (Medicine and Nursing) met to explore a potential interdisciplinary research project examining health care literacy which would include colleagues from other local higher education institutions. The pilot project received internal funding. After implementation it was presented at a national and an international venue, and reported in two peer-reviewed journals. The original researchers are now exploring national grant funding opportunities. Networking and visioning contributed to the success of this partnership.

Another example, which demonstrates networking, leadership, and vision, involved the establishment of a Health Careers Consortium to address the shortage of health care providers in a local community. Three nursing leaders met for dinner and discussed ways to address the nursing shortage. Each went back to his or her organization to obtain support. Other community leaders were identified and invited to participate. As a result, the Health Careers Consortium is currently composed of 17 organizations, and continues to receive multiple requests for membership from other interested parties. The consortium has developed a recruitment video tape; provided information about scholarships; participated in multiple Health/Career/Business fairs; been recognized in newspapers, journals, and television; collaborated with a Workforce Board to obtain $380,000 in funding for skill development and incumbent worker programs; and aided in the establishment of an Area Health Education Center.

At about the same time as these two previous examples were occurring, the local Chamber of Commerce was examining the impact of health care on the local economy through a medical expansion committee. The Regional Deans were invited to participate on the committee and to present issues related to their profession at the annual Chamber Board Retreat. This resulted in the Chamber sponsoring a project in which the nursing shortage was addressed, an endowed scholarship fund of over $50,000 for local nursing students was established by a local bank, and funding to support faculty salaries at a community college was obtained.

A further example shows how bringing the right people together at the right time through networking helped to confront an identified challenge and improve the health care of the community. The challenge was the lack of professional Registered Nurse (RN) circulator nurses available for the acute care facilities in the region. A group of individuals involved in other projects came together to discuss and brainstorm about this concern. From these sessions a course was developed to increase the number of RN circulator nurses. The course utilized multiple experts in the region to provide instruction while three different acute care facilities in the area provided a comprehensive look at the requirements of the role of the RN circulator nurse.

Our last example illustrates the important roles of networking and vision as multiple institutions of higher education and state agencies partnered to confront the growing challenge of the nursing shortage. Within the state of Texas alone, over 4700 nursing student applicants for the 2003/2004 academic school year were denied admission into any nursing program. This number does not include duplication of applications across the state. As a result, innovative strategies for opening additional educational opportunities were greatly needed. To address this shortage of nursing educational opportunities, a group of nursing programs have organized to seek a multi-million dollar grant to investigate innovative strategies for educating individuals to be RNs.

Conclusion

Overall, the experience of the authors is that one project leads to another. Neither of us set out with a strategic plan for collaborative projects. However, we found that as nurses we were already skilled as networkers, leaders, and visionaries. As the stakeholders realized the quality of work done by the members of the group, they were willing to engage in further projects with the group members. We found that developing the appropriate foundation for the initiation of a project was important. Also important was an emphasis on the quality of the work and effective implementation of the plans. Timely evaluation and reporting were also a key to our success. Time must be taken for sharing the results of the endeavor with the stakeholders. Without this closure, the stakeholders can become wary about engaging in future endeavors.

In summary, partnership opportunities are there for the taking when one remains cognizant of trends and issues within communities, organizations, and the profession. Being prepared to take the initiative is also very important as one project may mesh or overlap into another. An understanding of the process of collaboration enables leaders to develop and manage the environment to meet the needs identified within the community (Outhwaite, 2003). The elements of networking, leadership, and vision are all important as relationships between stakeholders are developed. By carefully addressing each of these areas, partnerships become strong, and beneficial outcomes follow.

Authors

Carol Boswell, EdD, RN
E-mail: carol.boswell@ttuhsc.edu

Dr. Boswell received her diploma from Methodist Hospital School of Nursing in Lubbock, Texas. After practicing for several years, she returned to school and was awarded a Bachelor of Science in Nursing from Texas Tech University Health Sciences Center in Odessa, a Master of Science in Nursing from Texas Tech University Health Sciences Center in Lubbock, Texas, and an EdD in curriculum development from Texas Tech University in Lubbock, Texas. Dr. Boswell has actively presented in local, state, national, and international venues. She has multiple publications related to health literacy, online teaching, research, and diabetes. She has been an educator for over thirteen years teaching at multiple levels, ranging from the Associate Degree level through the Graduate level, and has also presented continuing education offerings.

Sharon Cannon, EdD, RN
E-mail: Sharon.cannon@ttuhsc.edu

Dr. Cannon received a Bachelor of Science in Nursing from St. Louis University, after which time she practiced in various nursing roles and health care settings. She later received a Master of Science in Nursing from Southern Illinois University – Edwardsville and an EdD in educational administration and curriculum and instruction. Sharon has presented papers/poster at local, state, national, and international levels, and has published multiple manuscripts and several book chapters. She has been an educator/administrator in a variety of areas, including hospitals, continuing education programs, and schools of nursing at the ADN, BSN, RN-BSN, and graduate levels.