Jody Hoffer Gittell

Pure bureaucratic organizations don’t work well in dynamic environments due to their low bandwidth and limited adaptability - although they are known to be highly scalable, replicable and sustainable. Pure relational organizations are highly effective in dynamic environments given their high bandwidth, adaptability and support for collaboration - but they are challenging to scale, replicate and sustain over time. There has been much innovation in the fields of organizational sociology, organization design, and organizational consulting recognizing the advantages of both bureaucratic and relational organizations and suggesting potential hybrids - such as post-bureaucracy (Donnellon & Heckscher, 1994), enabling bureaucracy (Adler & Borys.1996), ambidexterity (O’Reilly & Tushman, 2008),

We focus in this essay on relational bureaucracy as a hybrid design that seeks to capture the advantages of the pure bureaucratic and the pure relational forms (Gittell & Douglass, 2012; Douglass & Gittell, 2012). Relational bureaucracy distinguishes between structures and relationships, while seeing structures and relationships as forming two ends of a continuum. Relational bureaucracy shows how to scale, replicate and sustain role-based reciprocal relationships using structures that are intentionally designed for this purpose, building on relational coordination theory.

Complex global challenges cut across organizational and sectoral boundaries, increasing calls for holistic responses. Seeing the whole across diverse stakeholders is challenging for participants in complex systems, yet doing so is essential for engaging effectively in systems change. A promising new method known as relational mapping, based on relational coordination theory, has been used to facilitate complex systems change. Here, we propose that relational mapping can be applied to help participants (1) see the whole in relation to the parts, (2) share their explicit and tacit knowledge, (3) engage in dialogue across distinct perspectives supported by the map as a boundary object, (4) reduce the impact of power differences, and (5) prepare to co-design interventions from multiple perspectives. This paper presents an illustrative case of relational mapping in the context of public administration in a South Carolina community engaging in complex systems change. Our analysis suggests a set of boundary conditions for the success of relational mapping, including the willingness of participants to seek integrative solutions to a conflict or problem and facilitation that is attentive to differential power and status among stakeholders. We conclude that relational mapping is a powerful, theoretically grounded method that enables the visual assessment of multi-level stakeholder relationships, preparing participants to engage in complex systems change and then present a template for use of relational mapping more broadly.

Health care organizations are increasingly relying on interprofessional teamwork to deliver high-quality and cost-efficient care, to create disruptive knowledge, and to address grand population health challenges. Thus, understanding how we can deliberately manage such teams in order to effectively coordinate care across occupational boundaries and disciplinary domains is of growing importance. This chapter reviews the conceptual basis and multilevel determinants of successful interprofessional collaboration in the health care sector, and highlights the key themes of relational coordination, a theory of performance and change that aims at transforming workplace relationships to achieve sustainable and desirable outcomes. Finally, adopting a relational perspective on human resource management (HRM), it introduces strategic relational human resource management (SRHRM) as a promising approach for managing coordination in interprofessional teams. The chapter concludes with a discussion of the implications for both researchers and practitioners.

It may be surprising for HR scholars and practitioners to learn about the dysfunctional outcomes of HR practices that are currently seen as “best practices.” The chapters in Part III show how job redesign typically accomplishes the opposite of what is needed (McBride), how the lack of voice for health care workers further demoralizes and disengages them (Hague et al.), and how retention and recruitment challenges are exacerbated by the unnecessarily difficult nature of health care work (Williams). But these chapters also show how HR practices can be redesigned to fit the interdependent nature of the work and achieve better outcomes. One shows that high-performance work systems can be redesigned to address issues like workload and building connections across a status hierarchy (Kilroy). The final chapter shows how to design HR practices that build relationships across interdependent jobs, including those divided by the status hierarchy (Zhang et al.).

Background
The COVID-19 pandemic has been an unusually comprehensive crisis that has taken a toll on people in their roles both at work and at home, giving rise to a new normal.

Purpose
Relational coordination theory shows how communicating and relating for the purpose of task integration drives positive outcomes for workers, their clients, and their employers. The ecological theory of work–family spillover shows how relational dynamics from work spillover into family life, and vice versa. We build upon these two theories to understand how relationships at work impact work–life balance and worker well-being, especially in times of crisis.

Methodology
This study was based on surveys of clinicians affiliated with a large California health system during the COVID-19 pandemic. Mediation and multilevel logistic regression models were used to assess how relational coordination among colleagues impacts well-being (job satisfaction and lack of burnout) through its effects on work–life balance (schedule control and personal time).

Results
A 1-point increase in relational coordination tripled clinician odds of having schedule control (OR = 3.33, p < .001) and nearly doubled the odds of having adequate personal time (OR = 1.83, p < .001). A 1-point increase in relational coordination nearly quadrupled odds of being satisfied with their job (OR = 3.92, p < .001) and decreased odds of burnout by 64% (OR = 0.36, p < .001). The impact of relational coordination on worker well-being was mediated by greater schedule control and personal time.

Conclusion
Relational coordination among colleagues impacts worker well-being by enabling greater control over one’s schedule and more personal time, thus creating a positive spillover from work to home in times of crisis.

Practice Implications
In times of crisis, leaders should prioritize relational coordination among colleagues in order to support their resilience both at work and at home.