title: Organizational dimensions of relationship-centered care. Theory, evidence, and practice.
abstract: Four domains of relationship have been highlighted as the cornerstones of relationship-centered health care. Of these, clinician-patient relationships have been most thoroughly studied, with a rich empirical literature illuminating significant linkages between clinician-patient relationship quality and a wide range of outcomes. This paper explores the realm of clinician-colleague relationships, which we define to include the full array of relationships among clinicians, staff, and administrators in health care organizations. Building on a stream of relevant theories and empirical literature that have emerged over the past decade, we synthesize available evidence on the role of organizational culture and relationships in shaping outcomes, and posit a model of relationship-centered organizations. We conclude that turning attention to relationship-centered theory and practice in health care holds promise for advancing care to a new level, with breakthroughs in quality of care, quality of life for those who provide it, and organizational performance.
authors.affiliation: The Health Institute, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, MA 02111, USA. dsafran@tufts-nemc.org
authors.forename: Dana Gelb
authors.initials: DG
authors.lastname: Safran
authors.forename: William
authors.initials: W
authors.lastname: Miller
authors.forename: Howard
authors.initials: H
authors.lastname: Beckman
mesh_terms: D058016:Health Facility Administration; D006801:Humans; D007400:Interprofessional Relations; D017146:Models, Organizational; D015279:Organizational Culture; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*