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Table 3 Summary of proposed CMOCs

From: Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

Context

Mechanism

Outcome(s)

PARTNERSHIP PERFORMANCE

Synergy and collaborative inertia

High partnership functioning and trust level

Synergistic working

Greater task achievement

Low partnership functioning and trust level

Collaborative inertia

Lesser task achievement

High faith

Synergistic working

Greater performance

Greater, appropriate strategies of interpersonal communication

Synergistic working

Greater performance

Greater confidence (in mandated or integrative collaboration)

Synergistic working

Greater performance

Perception of progress and performance

Intra-organisational conflict

Lessened perception of progress

Reduced faith

Unambitious aims

Lessened perception of progress

Reduced faith

Absent actors

Lessened perception of progress

Reduced faith

Greater organisational flexibility

Enhanced perception of progress

Enhanced faith

Workforce instability

Lessened perception of progress

Reduced faith

Conducting ongoing evaluation

Enhanced perception of progress

Increased faith

Clarity of roles

Enhanced perception of progress

Enhanced faith

PARTNERSHIP FUNCTIONING

Conflict

Appropriate accountability arrangements

Reduced conflict

Enhanced trust

Slow pace of development

Conflict

Reduced trust

Higher cultural compatibility

Reduced conflict

Enhanced trust

Shared vision

Reduced conflict

Enhanced trust

Improper cessation of collaboration

Increased conflict

Reduced trust

Task failure

Increased conflict

Reduced trust

Trust

Destructive conflict resolution strategy

Reduced trust

Reduced faith in partnership, reduced perception of progress

Constructive conflict resolution strategy

Improved trust

Improved faith in partnership improved perception pf progress

Existing successful collaborations

Better initial trust

Greater ambition in objectives

Legal agreements

Greater initial trust

Greater risk threshold, greater ambition

Reduced trust

Reduced risk threshold and aim ambition

Reduced perception of progress

Overambition

Lack of achievement

Reduced trust

Underambition

Lack of achievement

Reduced trust/faith

Significant conflict

Critical trust threshold reached

Partnership dissolution

Confidence

Greater formalisation (in context of mandated or integrative collaboration)

Greater confidence

Increased synergy

Power

Larger organisational size

Domination by single partner

Reduced trust

Unequal resource distribution

Domination by single partner

Reduced trust

Mandated collaboration

Power imbalance

Reduced initial trust

Faith

Involvement of stakeholders

Increased authenticity of partnership

Increased faith

Inauthentic partnership

Reduced faith in partnership

Reduced perception of progress

Reduced faith

Critical threshold of faith reached

Partnership dissolution

Interpersonal communication/coordination

Conflicting cultures

Increased interpersonal communication

Conflict

Greater geographical proximity of partners

Increased interpersonal communication

Fostering trust

Leadership

Collaborative leadership style

Improved trust

Better perception of progress

Mandated collaboration characterised by low initial trust

Combative leadership, pushing out of dissenting partners

Shared vision

Voluntary partnership

Combative leadership approach

Dominating power hierarchy

Cultural integration

Inclusive leadership style

Easier cultural integration

Greater trust

Perception of task complexity

Interoperable systems

Reduction in perception of task complexity

Enhanced interpersonal communication

Larger organisational size

Greater perception of task complexity

Greater requirement for initial trust due to greater perceived risk

Larger organisational size

Greater perception of task complexity

Slowed communication

Simpler aims of collaboration

Reduced perception of task complexity

Lesser trust requirement

Favourable regulatory environment

Reduced perception of task complexity

Enhanced perception of progress