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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