Advances in technology and the proliferation of mobile devices have changed the way we communicate with each other, and social networks challenge our notions of hierarchically ordered organisation and information flow. Social networks like Twitter are usurping the power of formal, hierarchical networks, and technology is disrupting structural boundaries within organisations (Baker, 2014).

The terms networking, collaborating, partnering and forming an alliance or coalition all involve working with someone else, or with others, in some kind of formal or informal relationship, to perform a task and achieve a shared goal. However, networking is positioned on a partnership continuum that moves from networking to coordinating to cooperating and finally to collaborating. Most partnerships are built on a clear purpose and value. They move up and down this continuum, which shows progression based on degree of commitment, change required, risk involved, levels of interdependence, power, trust and a willingness to share turf (Himmelman, 2001).

Coordination is one step up from networking on the partnership continuum and involves exchanging information for mutual benefit and altering activities for a common purpose. It requires more time and trust but does not include sharing the turf. Cooperation, which means working together to achieve a shared goal, is similar to coordination, but it also requires significant amounts of time, high levels of trust and significant sharing of turf. It may require complex organisational processes and agreements in order to achieve the expanded benefits of mutual action. Finally, collaboration involves all of the above plus a willingness to increase the capacity of another organisation for mutual benefit and a common purpose. It is defined as working together on a project or activity. It requires the highest levels of trust, considerable amounts of time and extensive sharing of turf. It involves sharing risks and rewards but can produce the greatest benefits.

According to Marinez-Moyano (2006), networking is a recursive process, in which two or more organisations work together to realise shared goals. This is more than the intersection of common goals seen in cooperative ventures; instead, it is a collective determination to reach an identical objective. This may be an endeavour that builds new understanding by sharing knowledge or learnings and achieving consensus. It could be the result of a collaborative trial of a new protocol to reduce variation in clinical practice, or changing processes of patient referral to improve access to care while enhancing cost performance.

Networking is widely seen by the health sector as a crucial way of sharing risk, boosting research productivity, discovering new therapies and ultimately reinventing the way healthcare is delivered. Public and private sector healthcare providers and academia are forming an array of partnerships and strategic networks to drive innovation. These require trust and openness in sharing resources and data, which at times can be challenging. De Long and Fahey (2000) maintain that the level of trust that exists in an organisation greatly influences the amount of knowledge that flows both between individuals and from individuals into the organisation’s records.

An important development in strategic networking is the activity of co-creation. An example of this is the development of the Melbourne HealthPathways, in which four Victorian Medicare Locals and four Victorian health services (hospital networks) collaborated to develop web-based clinical pathways, using evidence-based practice and the latest research, to guide general practitioners to make appropriate clinical decisions when referring their patients to hospitals. The framework they used was based on the health pathways model stemming from the Canterbury Initiative in New Zealand (Timmins & Ham, 2013). The benefits of this co-creation collaboration and networking approach included identification of new opportunities and added credibility to the quality frameworks already in place. The network partners wanted research that was practical, with commonsense outcomes that people could understand, and that was normally achieved (Janamian, Jackson & Dunbar, 2014).

A further example of strategic networking is NHMRC Partnerships for Better Health, designed to create Partnership Projects to foster partnerships among decision-makers, policy-makers, managers, clinicians and researchers (National Health and Medical Research Council, 2013). This initiative provided funding to create new opportunities for researchers and policy-makers to work together for a mutual interest. This could include answering a specific research question to influence health and wellbeing through changes in the delivery, organisation, funding and access to health services.

As indicated earlier, networking often involves just the sharing of information or just keeping up to date in an area of common interest. It can have a narrow focus on information related to the introduction of a new procedure for handling patient feedback in a health service, or have a broader focus such as sharing updates on the introduction of major health reforms, like the reforms to primary healthcare in Australia and the introduction of casemix funding to Australian hospitals.

Networking can be a powerful way of sharing learning and ideas, building a sense of community and purpose, shaping new solutions to entrenched problems, tapping into hidden talent and knowledge, and providing space to innovate and embed change (Randall, 2013). On the other hand, networking can have a more active meaning, of engaging with colleagues attending a college professional development seminar or holding a cross-sectoral health-planning meeting to facilitate better coordination of services, or engaging online when updating profiles on LinkedIn, or adding to a professional interest group’s blog. All of these activities can be described as different forms of active networking with varying levels of engagement.

Leadership and networking

Networking is primarily about relationship-building. It is, in fact, a leadership capability that involves building and maintaining genuinely helpful relationships with other people for mutual benefit. It is about creating a diversity of connections and win–win alliances with others through nurturing relationships that require some degree of trust. As a leadership capability, it can be learned and also nurtured with practice.

The ability of health managers or aspiring health leaders to develop networks, coalitions and partnerships is recognised as something worth developing in the leadership frameworks of the Australasian College of Health Service Management, Health Workforce Australia, the American College of Health Executives and the Canadian College of Health Leaders. Hence, conference and professional development events are likely to be structured to allow reasonable networking time.

Ibarra and Hunter (2007), in their work with emerging managers, discovered that there are three distinct but interdependent levels of networking, which are personal, operational and strategic. All three levels play an important role in developing managers to become leaders. Personal networking boosts personal leadership development, operational networking assists managers to meet current internal organisational responsibilities, and strategic networking opens managers’ eyes to new organisational directions and the stakeholders they need to enlist to achieve their goals. While managers differ in how well they pursue operational and personal networking, almost all of them underutilise strategic networking. It appears the reasons are both attitudinal and behavioural. Managers often describe networking as somehow manipulative or insincere instead of being part of the role of a leader.

Often, the attitude of managers is that their comfort zone and interests lie in the strong command of the technical components or tasks of their jobs and in accomplishing their personal or their team’s objectives. When challenged to move beyond their functional specialties and address strategic issues facing the organisation, many managers do not immediately grasp that this will involve relational activity, not analytical tasks. Nor do they easily understand that meetings and interactions with a diverse range of stakeholders are not distractions from their ‘real work’ but are actually part of what it is to be a leader (Ibarra & Hunter, 2007).

Personal networking

While effective personal networking can be more narrowly defined as being based on a genuine interest in assisting professional colleagues or significant others, networking is rapidly being recognised as a critical leadership skill impacting a manager’s career and organisational effectiveness. Research indicates that as high-performing organisations try to develop their future leaders and assess the leaders they currently have, they will explicitly indicate that the abilities to manage relationships across boundaries and to sell ideas are critical leadership competencies (Ibarra & Hunter, 2007).

Personal networking is a technique for broadening a manager’s professional knowledge beyond their usual work setting of acute, sub-acute or primary healthcare or aged care services. It enables managers to understand issues confronting other managers in allied organisations, both public and private, and to perhaps find common ground with managers outside their usual professional circles.

There are a number of avenues through which personal networking can be facilitated. At a one-to-one level, professional mentoring or coaching can play an important developmental role in establishing personal networks, by firstly gaining a broader understanding and secondly receiving important referrals to key individuals. Mentoring and personal networking can provide a safe space for a manager to undertake personal development and lay a real foundation for strategic networking.

Personal networking is mainly external, consisting of discretionary links to people who often share a common interest or provide possible career opportunities. Personal networks can represent useful referral potential and are an important first step for a manager in transitioning from being operational to strategic. It is part of the development of personal leadership to better understand one’s inner self and open further avenues for communication.

However, to avoid the possibility of feeling that personal networking is ultimately time-wasting, a health manager needs to link their personal connections to organisational goals as part of a broader strategy. Leveraging a personal network through, say, a professional college relationship could assist a health manager interested in hospital performance, and sharing a common interest with a senior colleague could facilitate a move from a private sector role with a health insurer to a health department role overseeing public hospital performance. Linking the activity of personal network–building to career advancement, to developing one’s knowledge of what constitutes efficient hospital performance, can benefit a health insurer to manage risk around hospital cost claims experience. The benefit of becoming a strategic networker within a health insurance company becomes clearer.

Personal networking can be either face-to-face or virtual. Increasingly, personal networking is facilitated through electronic means by the use of email, LinkedIn or internet blogs or groups, sometimes enabling personal networks to extend globally to colleagues in other countries. This is useful if health managers are wishing to extend their reach into other health systems, facilitate study tours or undertake international visits. International networking can also cast light on how other health systems have tackled health issues in quite a different manner. At a group level of personal networking, membership of professional associations, attendance at college-continuing professional development activities and keeping in touch with university alumni all assist health managers to gain new perspectives that allow them to advance in their careers.

However, quite often constraints for managers engaging in personal networking are time limitations and pressures of completing immediate work commitments. It is important that managers commit time to ensure personal networking opens up future career opportunities.

Reid Hoffman, the co-founder of LinkedIn, maintains that it is important for individuals to evaluate the type of business relationship they are in, so they know how to invest in each person. The more risky ‘transactional relationships’ require individuals to ensure a stream of short-term rewards for them so they constantly feel they are getting something out of the relationship. Hoffman argues that the more valuable and perhaps the more strategic relationships expect commensurate investment of time and energy over time by both parties (‘How LinkedIn’s boss links in’, 2013).

Operational networking

Operational networking becomes important when a health manager needs to build good working relationships with the senior managers, work colleagues and staff who can help them get their job done more effectively. The purpose of operational networking is to ensure coordination and cooperation among people who have to know and trust one another in order to accomplish their immediate tasks. That isn’t always easy, but it is relatively straightforward, because the task provides focus and a clear criterion for membership to the network. Either someone is integral to getting the job done, or they are not.

Generally, operational networking is internally focused, more concerned with sustaining cooperation within the existing network in the organisation than with building relationships to face unforeseen challenges outside the organisation. Operational networking can function within the work team, between departments or divisions in a larger organisation or even interprofessionally, in the case of multidisciplinary care teams delivering acute care or rehabilitation, or managing chronic disease in the primary healthcare setting. But as managers move into leadership roles, their network must become more externally focused and future-oriented.

Strategic networking

When health service managers begin the delicate transition from functional manager to organisational leader, they start to concern themselves with broad strategic and organisational issues. Lateral and vertical relationships with other functional or business unit managers outside the immediate control of the health service manager become important links, indicating how their own contribution fits into the organisational picture. Thus, strategic networking links ‘the aspiring leader into a set of relationships and information sources that collectively embody the power to achieve personal and organisational goals’ (Ibarra & Hunter, 2007, p. 43).

As an example, clinical directors, nurse unit managers or allied health department heads may be thrust into a clinical leadership role due to their organisational skills or because of seniority. The rise in managerialism in healthcare reflects organisational demand for efficiency and effectiveness in the delivery of healthcare services. The demand for innovation and continuous improvement in quality of health service delivery and the relentless push to improve productivity in the model of service delivery are about changing the behaviour of clinicians and patients. The clinical manager is well placed to influence these outcomes.

Leadership for successful innovation for the clinical manager often involves leadership skills like the exercise of political astuteness and the development of alignment and sometimes coalitions across different interests implicated by the innovation, in both formal and informal alliances. It involves mobilising existing relationships and developing new ones to encompass the range of practices involved in innovation, as well as seeking funding from the board or department of health (Storey & Holti, 2013).

It is important that the healthcare organisation provides the right environment for the clinical leader or manager to develop properly (Leggat & Balding, 2013). The health service organisation should facilitate networking training in areas like communications, leadership and organisation, human resources and financial systems, and policies and procedures. Networking skills are a capability that can be learned by the transitioning clinician.

The shift from clinician to clinical manager also involves a shift in mindset. Many managers need to change their attitudes about the necessity for networking. For the clinician, the mindset must shift from the highly valued individual patient focus to organisational objectives, from a narrower clinical focus to a broader organisational and strategic focus. This can often result in a challenge to their identity, from having personal clinical credibility to having a role in management of people and resources, in which they are less confident. The clinical manager will need organisational support to gain the required management credibility in this new role. At a personal leadership level, unless clinical managers shift their mindset about valuing their management role, they will not allocate sufficient time or effort to getting the job done.

The transition from clinician to manager can be greatly assisted by maintaining clinical networks and leveraging these to develop and support the building of necessary management skills. By encouraging the sharing of ideas around intractable clinical process problems, a clinical manager’s management challenges can be more effectively addressed.

Organisations can support clinician managers by providing opportunities for internal networking with other managers and encouraging attendance at suitable external events. Developing clinical managers might accompany senior managers at networking events to enable role-modelling of appropriate networking behaviours, or organisations might suggest relevant external websites (for example, LinkedIn) that can assist in further developing personal networks. Organisations can also incorporate networking performance measures into assessment processes and appraise the clinical manager’s skill in engaging with others. In these ways, the organisation sends a strong signal that it values networking capabilities.

The Australian Primary Care Collaboratives Program is an example of strategic networking. It used the Breakthrough Series collaborative methodology designed to help organisations close the gap in performance by creating a structure in which teams can easily learn from each other as well as from recognised experts in selected topic areas. General practices that participated in the program attended a series of learning workshops, undertook improvement and change activities in their health service and collected monthly data to track their progress. Learning workshops allowed participants to network, hear from topic area and quality improvement experts and actively share knowledge and experiences with their peers. The workshops enabled practice teams to test ideas and carry out change.

Interorganisational networking

Operating beside organisational members with diverse backgrounds, objectives and incentives needs a manager to work through networks that they require to compete for resources. Internally, the clinical manager will need to work closely with the hospital management team, comprising the directors of nursing, medical, finance and allied health services. They form part of a community of practice network, with expertise in leading and organising health professionals, managing finances and assessing operational performance within the organisation.

Externally, clinical managers may be part of an interorganisational community of practice network, in which groups of managers come together to learn, address organisational issues and, where possible, drive innovative practices or design alternative service models. These types of knowledge alliances are important ways for organisations to increase their learning in order to innovate and remain competitive (Ropes, 2009). Knowledge management in healthcare is emphasised in evidence-based medicine approaches and through collaborative efforts leading to the development of clinical pathways where context knowledge is essential (Yamazaki & Umemoto, 2010).

There are many examples of networks that have formed to facilitate interorganisational learning. For instance, Networking Health Victoria operated numerous networks of primary health organisations tasked with improving the coordination of primary healthcare services around chronic disease management. These networks came together to better coordinate after-hours primary care delivery, aged care, mental health services, telehealth services and health data collection, among many other areas. Networking Health Victoria provided insight into the interorganisational networking processes that were involved. The program operated on a facilitation model, relied on personal contacts and worked with its networks in a very structured manner. All network meetings strived to have content-rich agendas utilising data, critiques, analyses, ‘Plan, Do, Study, Act’ (or PDSA) cycles and follow-up activities. There was a strong sense of common purpose and expected outcomes from events and network meetings. Meetings were well documented, follow-up was always initiated, and organisational learning was subsequently shared.

Importantly, networking in the 21st century is ably assisted by systems of software, tools and technologies. Networking Health Victoria used client relationship management software from Salesforce to track key contacts and to support their networks. The software generates reports and dashboards of key metrics related to all activity with key stakeholders.

Intraorganisational networking

Research has demonstrated that at an operational level, an individual’s productivity is inextricably linked to their networking capability (Ferreira & Du Plessis, 2009). Effective networkers within organisations reap rewards such as hastened career progression, capitalisation of leadership opportunities, greater job satisfaction and business success.

At an intraorganisational level, studies at Toyota have demonstrated the role of network knowledge resources in influencing an organisation’s overall performance. In a sample of United States automotive suppliers selling to both Toyota and United States automakers, Pittaway, Robertson, Munir, Denyer and Neely (2004) found that greater knowledge-sharing on the part of Toyota resulted in a faster rate of learning within the suppliers’ manufacturing operations devoted to the company. Indeed, from 1990 to 1996 suppliers reduced defects by 50 per cent for Toyota versus only 26 per cent for their largest United States customer (Dyer & Hatch, 2006).

Recent work on competitiveness has emphasised the importance of business networking for innovation. A systematic review of research by Pittaway et al. (2004) linking the networking behaviour of firms with their innovative capacity found that the principal benefits of networking include risk-sharing, obtaining access to new technologies and external knowledge, speeding products to market and pooling complementary skills. The evidence also shows that those firms which do not cooperate and do not formally or informally exchange knowledge limit their knowledge base in the long term and ultimately reduce their ability to enter exchange relationships. At an institutional level, national systems of innovation play an important role in the diffusion of innovation in terms of the way in which they shape networking activity. Evidence suggests that network relationships with suppliers, customers and intermediaries such as professional associations are important in affecting innovation performance and productivity (Pittaway et al., 2004).

Summary

• Networking is relationship-building and is a supportive system of sharing information among individuals, groups and organisations with a mutual interest.
  
• Networking is part of a partnership continuum that has its highest form in collaboration, involving high trust, time commitment and risk-sharing.
  
• Health service managers need to navigate three levels of networking: personal networking, operational networking and strategic networking.
  
• Networking is an important management capability that can build influence and be applied at a personal level for leadership development or at an intraorganisational level for organisational development and improvement.
  
• Networking can be applied at an interorganisational level for the purposes of research, knowledge management, process improvement and relationship development.

Reflective questions

1 Why is it important to understand the different forms of networking that are available?

Only gold members can continue reading. Log In or Register to continue

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)

Like this:

Like Loading...

Related

Related posts:

1. Holding to account
2. Creativity and visioning
3. Partnering with stakeholders
4. Workforce-planning

Stay updated, free articles. Join our Telegram channel

Join