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Relational Coordination in VA

Home | Journal Club

Relational Coordination in VA Program
is now in its sustainment phase and
no longer accepting new applications.

Thank you for your participation and support over the last three years.

If you still wish to use relational coordination in your work, please contact for more information.

Funded through a 3-year SDR grant with HSR&D, the Relational Coordination in VA program offers VA researchers and staff access to the Relational Coordination Survey at no-cost along with educational opportunities to learn about the role of Relational Coordination in healthcare.

What is Relational Coordination?

Relational Coordination is a mutually reinforcing process of communicating and relating for the purpose of task integration.

Relational Coordination has been shown to improve team performance and high reliability through improved communication and relationships within and between teams.

Relational Facilitation Guidebook

This guidebook offers an introduction to relational facilitation, a four step implementation strategy that combines the theory of relational coordination with the implementation strategy of facilitation to assess and improve relationships and communication within and between teams to support program outcomes.

Who is the Guidebook for?

  • This guidebook is for anyone who wants to improve work processes.
  • The ideal readers are novice to expert VA investigators, clinical staff implementing new practices, and evaluators of evidence based practices.

Download the Relational Facilitation Guidebook.

What is the RC Survey?

The RC Survey is an evidence-based 7-item survey that enables researchers and organizations to understand where relationships are strongest/weakest within and between teams in a work process and determine next steps to improve performance and increase relational coordination. Download a copy of 7-item survey.

  1. Frequent communication: How frequently do people in these groups communicate with you about [insert work process]?
  2. Timely communication: How timely is their communication with you about [insert work process]?
  3. Accurate communication:How accurate is their communication with you about [insert work process]?
  4. Problem solving communication: When there is a problem in [insert work process], do people in these groups blame others or try to solve the problem?
  5. Shared goals: How much do people in these groups share your goals in [insert work process]?
  6. Shared knowledge: How much do people in these groups know about the work you do with [insert work process]?
  7. Mutual respect: How much do people in these groups respect the work you do with [insert work process]?

Through the RC in VA program, the RC Survey can be administered by research or operations teams using the survey platform of their choice at no-cost.

RC Analytics, a measurement and analytics company, will provide guidance on survey design, administration and data analysis to ensure project aims are aligned with the structure of relational coordination.



Disseminating and Sustaining Relational Coordination in the Veterans Health Administration

with Brigid Connelly
This presentation details the dissemination efforts and outcomes of the Relational Coordination in the VA (RC in VA) Program. Funded in 2018 as an HSR&D pilot project, the RC in VA program sought to increase awareness regarding the interdependence of work teams to ensure the delivery of high-quality, safe, and equitable care. The program impacted numerous VA strategic priorities and continues to be sustained by projects funded by funded by national VA program offices including CCICM & Pain Management, Office of Community Care, and the Office of Rural Health.

The Development and Application of Relational Facilitation for Care Coordination in the Veterans Health Administration

by Heidi Sjoberg
We joined relational coordination with facilitation to create Relational Facilitation, a new implementation strategy to support healthcare teams implementing evidence-based practices. This video provides background to the development of Relational Facilitation as well as findings from its implementation in a national care coordination program.

Understanding Relational Coordination Within and Across Service Lines in a Vertically Integrated VA Medical Practice Group

by Heba Naim Ali, MD, MS, PhDc ; Samuel Edwards, MD ; Martha Gerrity, MD, MPH, PhD ; Jody Hoffer Gittell, PhD
Seminar date: 4/17/2023
Description: In this Cyberseminar, Presenters will discuss:

  • What they learned from their pilot project, so far, about building relational coordination among VA leadership teams
  • How the Relational Coordination Survey is supporting data-driven change
  • What the role of leadership is in building relational coordination, and how can it be developed

Study investigators used relational coordination (RC) – communicating and relating for the purpose of task integration - as the guiding theory and the RC Survey as a tool for the executive leadership team (ELT) at VA Portland Health Care System (VAPORHCS) to assist service line leadership teams in addressing the challenges they face. The COVID-19 pandemic increased demand for care and exacerbated staff shortages, further contributing to employee burnout and turnover, and added stress to leadership teams who strive to provide safe high quality to veterans. VAPORHCS is led by an executive leadership team (ELT) that oversees seven major patient care service lines. The ELT was aware the pandemic and staffing shortage increased stress on service line leadership teams and sought ways to assist these teams. Presenters will describe the approach used, RC survey results, facilitation needed for debriefing results with leadership teams, and how results were discussed and used by the teams.

DOWNLOAD: PDF handout | Audio only (mp3) | transcript not yet available

An Introduction to Relational Coordination

This brief four-minute video offers an introduction to relational coordination, a theory used to improve relationships and communication among healthcare teams. This video precedes the relational facilitation video and accompanies the Relational Facilitation Guidebook. Download the Relational Facilitation Guidebook.

Relational Facilitation

This video offers a brief introduction to the relational facilitation process and is designed to accompany the Relational Facilitation Guidebook. The content of this video is similar to what you’ll find in the guidebook, but presented in a visual and audio format. Download the Relational Facilitation Guidebook.

Video: RC in VA journal club: Relational Analytic Chapter 1


Video: Relational Facilitation for the VA Quadruple Aim QUERI
with Heather M. Gilmartin, PhD

This 9-minute educational video describes the background and implementation of relational facilitation for healthcare teams engaged in the Quadruple Aim QUERI. Grounded in the theory of relational coordination, this unique facilitation approach aims to assess and improve relationships and communication among and between teams to improve Veteran care.


Learn more about Relational Coordination in the VA?

Revising Relational Coordination: A Systematic Review

Listen to Dr. Jody Gittell speak about Building Relational Coordination for High Performance in the VA

VA studies that investigated Relational Coordination

Connelly et al (2021): A dissemination strategy to promote relational coordination in the veterans health administration: a case study

Gilmartin et al (2020): Practices to Support Relational Coordination in Care Transitions

Rosen et al (2020): Access to Pain Care from Compensation Clinics: A Relational Coordination Perspective

Anderson et al (2020): Care Coordination for Veterans with COPD: A Positive Deviance Study

Altalib et al (2019): Measuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination

Mohr et al (2019): Organizational coordination and Patient Experiences of Specialty Care Integration

RC in Healthcare Section for Publications

Spitzer et al (2023): Developing Relational Coordination: A Qualitative Study of Outpatient Mental Health Teams.

House et al (2021): Relational coordination and staff outcomes among healthcare professionals: a scoping review.

Blakeney et al (2021): Sustaining improvements in relational coordination following team training and practice change: A longitudinal analysis.

Tingvold et al (2021): Shared goals, communication and mutual respect in multicultural staff teams: A relational coordination perspective.

Thygeson et al (2021): Relational interventions for organizational learning: An experience report.

Bligaard Madsen et al (2021): Relational coordination in inter-organizational settings. How does lack of proximity affect coordination between hospital-based and community-based healthcare providers?

IRB and Report Examples

Three (3) examples of approved IRB Informed Consent forms:
Example 1 | Example 2 | Example 3

Sample verbiage for folks to include in IRB/administrative/union documents regarding the access and handling of RC Survey data

A sample of a RC Survey report

An example of a Union Notification document used when surveying VA staff

Listen to RC in VA Podcast Episode on Health Findings in Focus

The first episode of the new podcast Health Findings in Focus features an interview with Heather! It is a great introduction to Relational Coordination and what we want to accomplish. Have a listen:

SGIM 2022: Enhancing Interdisciplinary Collaboration and Team-Based Care in the Times of COVID-19 The Role of Relational Coordination

With Brigid B. Connelly, Heather M. Gilmartin, Christine D. Jones
April 2022

Download the presentation

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For more information or a consultation with the RC in VA program team about your project, contact

Our Team


Brigid Connelly, BA
Title: Project Manager

Heather Gilmartin, PhD, NP
Title: Project Lead

Ready to Apply?

Simply download the Relational Coordination in VA program application and send it to: