Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
The Team Advantage: Relational Coordination in Veterinary Practice
Veterinary teams are complex systems where communication, shared goals, and mutual respect directly impact workplace satisfaction and staff retention. In this enlightening conversation, researchers Natasha Janke and Jason Coe reveal groundbreaking findings on the power of relational coordination in veterinary practice.
Originally developed in the airline industry to understand Southwest Airlines' exceptional performance, relational coordination has transformed healthcare delivery across multiple fields. Now, for the first time, this powerful framework has been applied to veterinary medicine with remarkable results. Natasha explains that relational coordination thrives in environments characterized by time pressure, uncertainty, and interdependence between roles—a perfect description of the veterinary workplace.
Their research demonstrates significant positive associations between relational coordination and healthier psychological workplace climate, increased job satisfaction, and perhaps most critically for practices struggling with staffing challenges, reduced intention to leave. By focusing on seven core components—frequent, timely, accurate, and problem-solving communication, alongside shared goals, shared knowledge, and mutual respect—veterinary teams can transform their workplace culture.
Dr. Coe's twenty-year journey pursuing this research reveals how veterinary practices can use relational coordination as a diagnostic tool to identify specific areas for improvement rather than implementing broad, sweeping changes. The visual mapping of role interdependencies provides practice leaders with clear insights into team dynamics that might otherwise remain invisible. Both researchers emphasize the importance of including clients in the relational coordination framework, recognizing pet owners as essential members of the veterinary healthcare team.
Listen now to discover how strengthening your team's relational coordination could revolutionize your practice culture, improve staff retention, and ultimately enhance patient care. The evidence is clear—how we work together truly matters for everyone involved in veterinary medicine.
JAVMA article: https://doi.org/10.2460/javma.24.09.0570
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You're listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode, we chat about how veterinary team relational coordination is associated with healthier perception of workplace psychological climate, increased job satisfaction and reduced intention to leave with our guests Natasha Janke and Jason Ko.
Speaker 2:Welcome to Veterinary Vertex. I'm Editor-in-Chief, lisa Fortier, and I'm joined by Associate Editor, sarah Wright. Today we have Natasha and repeat guest and very prolific JABMA contributor. So thank you, jason, for joining us.
Speaker 3:Thanks for having us back.
Speaker 1:It's great to be here. All right, let's dive right in. So, Natasha, your JABMA article discusses the important role that relational coordination may have for veterinary practices, specifically in fostering employees' perceptions of the workplace psychological climate, enhanced job satisfaction and reducing employee attrition. Please share with our listeners the background on this article.
Speaker 4:Yeah, I'd be happy to Sarah.
Speaker 4:I think it's important to start with some background information on what relational coordination is for any listeners who may not be familiar with the concept.
Speaker 4:So relational coordination is a theory that describes the mutually reinforcing process of communicating and relating for the purpose of accomplishing work tasks that require interdependency among different roles or even within the same role. It's been identified to be most critical in settings that are characterized by time pressures, uncertainty, and consists of a high level of interdependency between roles within a team. And so, as you can imagine, veterinary medicine is an ideal setting to start researching relational coordination, because we have seen that patient care increasingly involves veterinary personnel in different roles with different levels of experience, training and responsibilities. So relational coordination was initially developed in the airline industry, actually, and there's been quite extensive research done within human health care, and consistently it's been found that an association has been found between relational coordination and a reduction in medical errors, improved efficiencies and overall positive health outcomes for human patients. So this is actually the first study that we are aware of to measure relational coordination in the context of veterinary medicine, which is really excited to take that first step into this world of relational coordination within the veterinary profession.
Speaker 1:Very cool. We are very happy to have that work in JAPMA. So what are some of the important take-home messages from this article?
Speaker 4:Yeah, that's a great question, Sarah.
Speaker 4:I think one of the biggest take-home messages here is that how teams work together really does make a difference for not only veterinary teams but clients and, of course, patients, and we're really just starting to create a foundation of evidence around this work within the veterinary profession.
Speaker 4:I think the results do speak for themselves, in that we found a significant positive association between relational coordination and workplace psychological climate as well as job satisfaction, and then we also found a reduction in employees' intention to leave their current role, found a reduction in employees' intention to leave their current role, and so we see that by promoting frequent, timely, accurate and problem-solving communication, as well as shared goals, shared knowledge and mutual respect, which are the seven components of relational coordination, there is an opportunity to positively enhance workplace culture and retention.
Speaker 4:There is an opportunity to positively enhance workplace culture and retention. I think I would also add to that to say that the article provides a foundation from which more work can be accomplished, and the alignment between our findings and what we're seeing from large-scale reviews in human medicine really speaks to the fact that there are opportunities to leverage findings from human medicine in order to develop interventions that we can. Opportunities to leverage findings from human medicine in order to develop interventions that we can then test within the veterinary profession, in order to identify training that can be implemented to improve team dynamics as well as outcomes of care, by enhancing relational coordination among team members.
Speaker 2:Yeah, thanks, natasha, that's a really great explanation among team members. Yeah, thanks, Natasha, that's a really great explanation. Now I'll turn to Jason for a second. Jason, your team has looked at all different aspects of veterinary medicine and when this one came in and I read it the first time, I was surprised and I thought Natasha did a great job of saying it really started in airline. How did you find out about this relational coordination and what sparked your interest in it in veterinary medicine?
Speaker 3:Yeah, so this brings me back 20 years, and I think I was doing my PhD when I came across the concept of relational coordination and I don't remember if it was. I had attended a presentation by Jody Hoffer-Gattel or I had learned or been introduced to it. Yet, as Natasha mentioned, I was introduced to this concept that was developed in the airline industry by Jody Hoffer-Gattell back in the 1990s, and at that time this was Jody's PhD work, where Jody went in and looked at the airline industry, because all of the airline industries were struggling at that time except for one, which was Southwest, and so it was really trying to understand what is Southwest doing differently from the other airline industries, and so, by examining how Southwest was operating, they were able to, or she, came up with this concept or theory of relational coordination, as Natasha's nicely described. It has since gone into human healthcare and I think it's now studied in about 70 different industries, and so since that time I've been really interested in understanding how might this relate to what we do in veterinary practice? Because, as Natasha mentioned, it's been identified as a work process or system that really lends well to environments where there's high uncertainty, where there's time pressures and where there's high interdependency between roles and if we think about veterinary medicine, that describes veterinary medicine in that you don't know what's going to walk through the door. We always are talking about the time pressures we're under, and then we appreciate the interdependency of roles, and it's not interdependency of relationships, it really is looking at the role level in terms of that, and so, because of that interest, I probably about 2010, did a study with Dr Irene Moore and some collaborators, which were published in JAVMA in 2014, I believe where we developed a team effectiveness tool for veterinary medicine, and part of that was out of my interest in relational coordination, which led to an interest in looking at teams, and in that study, we actually did measure relational coordination and we used it as one of our validations of our team effectiveness tool.
Speaker 3:In terms of the correlation with our measure of team effectiveness, I had hoped to do more with it at that point in time and, though team and team dynamics I wouldn't say was an area that was getting a lot of attention, was an area that there was a lot of support financially in terms of funding to pursue research Move forward.
Speaker 3:I had many years, and I would say four years ago, when the pandemic hit. I think that the veterinary profession experienced a situation where there was a lot of attention by many organizations on how we work as teams, and so it created an environment, along with funding that came along in the form of my VCA Canada Chair in Relationship Centred Veterinary Medicine. There was really perfect timing to again revisit this concept, and so it really positioned us to go out and do this work, and so, again, this has been a piece of research I've wanted to do for 20 years, and yet it just wasn't. The timing wasn't right, and now that timing has come and we've been able to produce this paper, which I believe will be the start of only a whole work area. So, lisa, you mentioned that you were a bit surprised that this came across. I expect we will have many more publications in this area over the next little while.
Speaker 2:Excellent. Look forward to reading those, and I won't be so surprised, given all that you both know about what things you saw in the airline industry and all the other industries that you mentioned by an aggregate, jason, what things in this article surprised you that might be unique to the veterinary field?
Speaker 3:Yeah, I think that's the piece is that I wouldn't say that there was anything that jumped out as a surprise per se. I think what is really important is that we have now taken something that has been established in other areas and shown that it is relevant to veterinary medicine, and so I do think that it's like anything, things are transferable, but until people see it in their own context, it's hard to understand how it will fit into our context, and so, as Natasha mentioned earlier, what this allows us is to take the work in roughly 70 other industries, look at the things that they've been able to demonstrate which were things that we expected and why we looked at some of the outcomes we did in this study and start to use that not only to assess relational coordination with veterinary medicine, but actually start to take some of the learnings on. How can we continue to enhance how we work as teams through this concept of relational coordination.
Speaker 1:So we talked about how this is just the beginning, really. So, natasha, what are the next steps for research in veterinary team relational coordination?
Speaker 4:Well, sarah, that's a very exciting question because we are already in the midst of those next steps, and so what I'll share about this study is that we examined relational coordination at the level of an entire veterinary organization, which included over 100 veterinary clinics, and so, with that in mind, we didn't quite reach the response rate to be able to look at relational coordination at the level of an individual hospital, where we're seeing the perceptions of teams that are working together day to day, and so our next steps are to narrow down our focus to include a smaller number of hospitals and aim for that higher response rate, and we've been working really closely to work on increasing our response rate from research participants so that we can look at relational coordination at the level of a hospital rather than the entire organization level of a hospital rather than the entire organization.
Speaker 4:So looking at those individual hospital-level results would allow us to use those results as a baseline in order to develop team training interventions that are more tailored to those individual hospitals rather than a more standardized approach that is, across a number of hospitals, and, long term, we do hope that this can be a scalable training so that we can reach a larger number of hospitals through this training approach to increase relational coordination, while also remaining individualized, so that when we're teaching or training teams how to work together and improve their relational coordination, we are focused on results and data that's coming from them as a team, rather than general results that are gathered from across a number of hospitals. So it's really exciting to see and think about where the direction of this work is going.
Speaker 2:Natasha and Jason, do you know about our technical tutorial video manuscripts?
Speaker 3:We do. I think we may have actually submitted a couple, so thank you.
Speaker 2:I think you have. I think this would be a great teaching learning tool to consider for a technical tutorial video.
Speaker 4:That's a great idea.
Speaker 3:We'll take that. Thanks, Lisa.
Speaker 2:A self-serving pitch and a lot of people learn right better through watching an example than reading it and, as you know, for the listeners they're also transcribed, so you can read and watch at the same time.
Speaker 3:Really feeds to different learning styles, for sure.
Speaker 2:Yes.
Speaker 1:And for our listeners. If you want to see some of their already published work, you can look at the Talking Physical Exam, which is one of our technical tutorial videos, on YouTube, our website and our social media channels. So AI is obviously a pretty hot topic and we're starting to see more AI in veterinary medicine. We actually just published a supplemental issue in AJBR just on AI and veterinary medicine. So, jason, do you see a role for AI in this area of research?
Speaker 3:Yeah, it's an interesting question just because of where we are with AI and the explosion of AI, and so I do feel like AI is going to have such a role in veterinary medicine, probably a transformative role in veterinary medicine over the next number of years.
Speaker 3:Exactly what that is, I'm sure you know we've got some ideas based on some of the things that are out there, yet I think you know could be anything we haven't even thought of in terms of what AI's role is, and so I think, in the work we're doing whether it be team-based clinical communication, I think the role of AI and how that contributes to relationships, particularly relationships between veterinary professionals and their clients, veterinary team members and how they work together AI is going to have a role, and so we're going to have to keep on top of that and see how that plays into the dynamics, Because, as Natasha mentioned, part of relational coordination is that relational dynamic that's based on shared goals, shared knowledge, mutual respect, and so I think AI could have a role in making sure people have shared knowledge, particularly, which contributes to shared goals and mutual respect. In terms of AI and the work that we're doing specifically, Natasha and I were chatting about this and it's interesting. You know, I see relational coordination as a potential diagnostic tool for veterinary teams to look at their team and identify where the areas that seem to be working well and what are opportunities for us to make some tweaks or adjustment. And I think, as we learn more and as systems come in place, to use this diagnostic tool to put in place tailored as Natasha mentioned strategies for strengthening a team or aspects of a team. I'm curious as what AI could offer in that, in terms of putting inputs in In the background.
Speaker 3:This AI is doing the things to make tailored recommendations for a team and aspects of the team to continually look at opportunities to enhance the work that's being done, Because I think by enhancing that team we enhance the culture of that team, as our publication has identified, and by enhancing that culture of the team we ultimately impact the clients and the patients that we care for. And so, to that point, I do think that the future is a little bit unknown in terms of that, but I do see the future as really having some real exciting opportunities, potentially in the realm of AI.
Speaker 1:Very cool. We're actually compiling these responses, so it's pretty interesting to see what everyone says to that question. And for those of you just joining us, we're discussing veterinary team relational coordination with our guests Natasha and Jason.
Speaker 2:Natasha, a lot of our listeners are junior authors or first or couple time authors, and so this next question can really help them understand how you got to this finish line, understand how you got to this finish line. So how did your training and previous work really prepare you to get all the way done and through, to get this all the way done to publication and now on the podcast, yeah, that's a great question and thanks for asking it, Lisa.
Speaker 4:I would say the foundation of my work has been clinical communication. So I completed a PhD in veterinary epidemiology with a focus on clinical communication, veterinarians and their clients, and then that expanded to examine the role of veterinary technicians to now involving the entire veterinary team. And since clinical communication or sorry, communication is a core component of relational coordination theory, I had that background coming into this work. But there's definitely a second component that I would add to that, beyond my PhD research. So over the last couple of years my work has began to heavily focus on team-based veterinary health care and I actually completed a two-year postdoctoral fellowship through an organization in Canada called MyTax and they promote collaborations between academia and industry called MyTax, and they promote collaborations between academia and industry.
Speaker 4:So through that postdoc I was able to spend a lot of time hands-on working with veterinary teams while I was conducting my research and I think that really gave me the opportunity to immerse myself in the everyday of what we were researching. So you don't always get that opportunity, but I think that was what really rounded out the communication and team-based veterinary medicine that you know came together to form this work and there's something really powerful about being able to, you know, live the experiences or live in the environment that you're studying, because you get to see things that numbers don't always capture and that can help you make sense of those numbers when you're collecting survey data, like we did with this study.
Speaker 1:Definitely something to be said about being boots on the ground, that's for sure. Now, Jason, as you know, this next set of questions is going to be super important for our listeners. The first one is going to be about the veterinarian's perspective. So, Jason, what is one piece of information the veterinarian should know about veterinary team relational coordination.
Speaker 3:Yeah, that's a big question and I think what I would say is we all appreciate that teams are complex, how teams work, and so particularly for veterinarians, oftentimes in that leadership role, when looking for how do I enhance my team or maybe the team's not functioning in the way that as a whole we want the team to work, where can I make changes? Because it's challenging to make one broad, sweeping change and expect that to really enhance the entire team. And so what I think relational coordination does is it offers us an opportunity to work to look at veterinary practices or teams within a veterinary practice, sort of at that system level, by looking at the interdependency between roles. And so in our publication there is a figure called a relational map and if you look at that it really demonstrates the complexity of the interdependency of roles within a veterinary practice. And yet that map can also be used to identify where are some of the elements as it relates to relational coordination working really well within our team and where are some opportunities that we could work with a connection within our team to really enhance that area of relational coordination.
Speaker 3:And you can use relational coordination at the practice level, as we did, or you could use it on a very specific work process, and so I think it offers a lot of different opportunities. And so, as I mentioned earlier, it becomes that diagnostic tool that we can get some information, reflect on that information and hopefully create a plan for how we want to support that area of our team. We implement that and then we reevaluate and it becomes this sort of cycle that we can use to really continue to support our team and bring our team up and support it in areas that we can identify through this theory and particularly those relational maps. And so I'd encourage people to take a peek at that in the article because it's pretty impressive to me on how complex a team is when you look at it in that way.
Speaker 1:Natasha on the other side of the relationship. What's one thing that clients should know about this topic?
Speaker 4:I love this question because I try to always think about the client when I'm conducting research.
Speaker 4:So clients can play a very important role in relational coordination and I always think of clients as being part of the veterinary team when I'm thinking about team-based veterinary health care.
Speaker 4:So, with respect to relational coordination, I would highlight the component of shared goals, because clients have an opportunity to enhance this aspect of relational coordination with their veterinary team by sharing their preferences, their values and their goals that they have for their pet with that team, so that the client's goals become integrated with the goals of the team. And I might be cherry picking this aspect of relational coordination because I have done a lot of work around shared decision making, so I do have an affinity towards that component of relational coordination. But if we're thinking about any aspect, any of the seven aspects of relational coordination, I do think it's important for veterinary professionals to view clients as team members because they really are such an essential component to providing care for that animal outside of the clinic. And, as Jason was talking about the relational maps, I have a goal of one day incorporating the client into that so that we're getting that full 360 perspective of relational coordination that actually includes the client's view on it as well.
Speaker 3:And I would just jump in to say, like I can't overemphasize Natasha's highlighting of the client as being part of this relational coordination map in terms of their role, and it's often left out, and so in human medicine, relational coordination at its fullest would include the patient as part of that and in our context, the client. And yet it's often left out and so we didn't have a way of doing that. Yeah, I think Natasha's point is critical that we should be thinking of the client as part of this team, because it's going to impact all the outcomes we're going for, whether it be within our team, our clients or our patients. So just want to emphasize that.
Speaker 2:I think that's particularly important when people veterinarians or medical professionals are first starting like to really listen to the client and take their feedback. You know, I remember when I was first starting and somebody would, you know, mention something and I was like, well, that's not medically important, but you know, just to really empower them to share that information and be part of the journey, at least they get to ask the fun question. Great, thank you guys again for being with us. Uh, super important topic across. As for us being our own patients or clients, really look forward to your future contributions. And as we wind down, we ask a little more fun question, sarah, and I think we can most of the time predict this, but we'll see. So we'll start with Natasha and then go to Jason. When you complete a puzzle, natasha, do you start with the border in the exterior or the middle? Do you start with a pattern, a color? How do you go about attacking a puzzle?
Speaker 4:I think I probably take a pretty common approach by starting with the exterior, but I do, as I'm pulling out those pieces, I do look for, you know, if I'm seeing patterns that are in the interior that might be probably easier to put together and I might pull those out and start working on both at the same time. I think it's rare that I would complete the border without having started the interior as well.
Speaker 2:I had you for a hybrid as well. Hybrid approach, Jason. How about you?
Speaker 3:Transparently. I don't know the last time I did a puzzle, and yet when I think about approaching a puzzle, I do think about the border, because I can see where that is supposed to go. And so I start there. And yet, as I was reflecting on this question, I was thinking I mean, I really approach research as a puzzle and so if I was to say how do I approach research, I probably approach research from the middle, working out to the borders, in terms of trying to understand and letting that guide me to where the next piece would be. So it's an interesting analogy when I start thinking about it in that way. Lisa.
Speaker 2:Yeah, great analogy.
Speaker 1:Yeah, way to tie in research to that. You're actually the first person to do that, I think, jason, and we ask that question a lot. Well, thank you again, jason and Tasha, for being here with us and also for submitting your research to JAVMA.
Speaker 3:Awesome.
Speaker 4:Thank you. Thank you so much for having us and to our listeners.
Speaker 1:you can read Jason and Tasha's article in JAVMA. I'm Sarah Wright with Visa40A. Be on the lookout for next week's episode and don't forget to leave us a rating and review on Apple Podcasts or whatever platform you listen to.
