Leading in Complexity: How to Facilitate Cross-Department Collaboration as a Healthcare Leader
Dr. Melody Sanders (name changed), the new medical director in a pediatric, hospital-based medical group, struggled to advocate for her team in meetings with senior leaders. In meetings that included the finance team and other administrators, she frequently felt misunderstood. As a result, she hadn’t been able to find a resolution on some critical issues, such as being paid for taking calls.
Leading in a healthcare organization means interacting with leaders across medical and non-medical departments. Unfortunately, it can often feel like each department is working on its own agenda in isolation. When teams exist in silos, they miss a valuable opportunity to gain the benefits of intentional collaboration.
Some common challenges leading across departments include:
Different languages and priorities: Clinical, operational, financial, and academic lenses.
Cultural divides: Each department has its own “microculture.”
Systemic barriers Include Misaligned incentives, unclear authority, and time pressures.
Human barriers: Ego, fear of losing control, and lack of trust.
In today's complex healthcare landscape, collaborative problem-solving is essential. Significant decisions impact various departments, such as finances and human resources, that will have their own perspectives and needs. Learning to collaborate across departments, while at times challenging, is a core leadership skill.
The Challenge of Leading Across Departments
Working across departments means that no one person should expect to get what they want in all matters. Effective healthcare organizations are complex adaptive systems. From a systems perspective, no decision occurs in a vacuum. Instead, decisions inevitably have an impact, positive and negative, across the organization.
Ultimately, the goal of every healthcare leader is a healthcare system that delivers the highest quality care possible. This occurs not through the autonomous function of each department, but as an adaptive system that emerges when each department functions optimally both individually and collectively.
Understanding how your organization functions as a complex adaptive system can help you leverage the opportunity created by cross-sector collaboration:
Take advantage of diversity Individual departments can share their unique experiences, perspectives, and expertise. Such learning opportunities create a rich foundation for informed decision-making.
Prioritize psychological safety Create spaces where all voices are welcome and encouraged. Safe settings are the foundation of productive collaborative convenings.
Align with your shared purpose Organizations that are unified in the vision can work towards a shared purpose. Alignment with concepts such as patient impact encourages better engagement and commitment.
Strategically share workflows Leverage the skills, resources, and expertise of individual departments to manage tasks efficiently and effectively.
Adaptive complex systems operate by recognizing both the independence and interdependence of their parts. That means in difficult matters where each party is pushing their own agenda, seeking coherence instead of consensus. As a healthcare leader, look for solutions everyone can live with, even if no one gets everything they want. Such alignment incorporates what best meets everyone’s needs.
This adaptive leadership approach shifts the focus from “winning” to cultivating relationships with a shared purpose. It also sets the stage for an iterative learning process that can strengthen the organization.
During one of my coaching sessions with Dr. Sanders, I explored how these meetings might feel somewhat like meetings with leaders from foreign nations. Dr. Smith’s challenge was to learn each nation's language to better collaborate with them and then translate her learnings to her team.
Non-clinical departments function within their unique microcultures. These microcultures have their own agendas, characteristics, expectations, and practices that can conflict with the wants and needs of clinical providers. While understanding these microcultures may not guarantee total alignment, it can establish a foundation for more effective working relationships.
Additional challenges, such as financial struggles, time pressures, or unclear expectations, can further complicate collaboration. However, recognizing these challenges can help decompress conflict when it arises.
Organizations are made up of people, so it’s no surprise that some conflicts result from relationship challenges. Directly addressing stressful relationship dynamics, using appropriate boundaries, and seeking supportive relationships can help navigate unstable relationships.
Working Across Boundaries
Cross-department meetings can facilitate trust building, better alignment, and collaborative solutions to issues that have a widespread impact. Instead of merely sharing information, use convenings to intentionally collaborate and work together.
Consider these strategies to approach cross-sector collaboration with greater intention:
Cross-functional conversations Structure meetings to facilitate sense-making and identify areas of coherence. Focus on how departments connect and work collaboratively to meet challenges. Try creating a systems map to visually represent the relationships between departments.
Both/and framing Make space for solutions that are expansive and inclusive across departments. Avoid “either/or” discussions that can become barriers to collaboration. Incorporate “What’s true for us” dialogue, allowing each department to share their pressures and constraints before working on problem-solving.
Small wins Engage in and highlight small projects that can create trust and shared success.
Mission moments Start meetings by inviting a couple of brief stories that spotlight the organization's mission.
Cross-department initiatives Invite non-clinical partners as collaborators on clinical initiatives and seek opportunities to join non-clinical initiatives.
Healthcare doesn’t happen in isolation; neither should leadership. The most effective leaders recognize that no single department, profession, or perspective holds the whole picture. Actual progress emerges when we’re willing to stay in the tension of difference long enough to find shared understanding.
Leading in complexity is about fostering a culture of innovation and collaboration, not controlling outcomes or forcing compliance. It’s about creating the conditions where trust, curiosity, and collaboration can take root. When we shift from defending our domains to connecting across them, we begin to build systems that reflect the interdependence at the heart of healthcare itself.
As you navigate your own leadership challenges, ask yourself: Where might I replace certainty with curiosity? Where could I build a bridge instead of a boundary?
Thriving leaders don’t just manage complexity; they learn to dance with it. Small, intentional acts of connection can change the culture of an entire organization. What’s one step you can take to initiate cross-departmental collaboration?
If you’re leading in complexity and want to strengthen your collaborative capacity, let’s talk about how coaching can help you lead across boundaries.