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How to Overcome the ‘silo mentality’ in our Health System

Most leaders in our healthcare system agree that it is very fragmented and uncoordinated due to a high degree of complexity. Due to this fragmentation, some stakeholders unfortunately develop a ‘silo mentality’ on how to solve a problem within their part of the system.


For example, when the Queensland Government several years ago introduced a solution to reduce waiting times in their Emergency Departments, it caused hospitals with bed shortages to close emergency departments, causing havoc to ambulance drivers and potentially risking patient lives. They were not aware of the ‘system-wide’ consequences of introducing a solution in one part of the organisation.


Everyone knows we need greater integration across silos in healthcare.  To do that, we need to change the way we think and form effective partnerships to jointly share resources, knowledge and solve problems. However, not many stakeholders know how to partner well, and therefore don’t do it very effectively.


In my last decade, I have been involved in managing over 100 partnerships of various types – from identifying and targeting partners, negotiating issues, restructuring and advising on strategic resolutions. It takes work to be able to enable effective partnerships, but the health outcomes and financial benefits can be enormous.


As such, I would like to share this 10-Step ‘Partnership Development Guideline’  that was developed from extensive research in the Future Solutions in Australian Healthcare White Paper. I’ve personally gained benefit from these guidelines as evidenced by our good relationship with healthcare organisations, industry bodies and the many outstanding contributors involved in this paper.

10-Step ‘Partnership Development Guideline’

1. Identify suitable partners by researching individuals, organisations higher up the healthcare value chain and lower down the value chain. Set your own internal criteria of what you are looking for.

2. Determine the level of partnership intended to be developed. (Partnerships include joint ventures, strategic alliances, coordination, cooperation or collaboration). Every level has advantages and disadvantages and the partnership may be flexible to change levels at any time.

3. Conduct research ~ Understand the value you can bring to your partner by researching all the available value offerings that your organisation can provide. Research what the needs are for the potential partner organisation.

4. Approach potential partner – for initial exploratory discussions. Establish the appropriate contact person, contact details, location and role of the person. (A ‘high touch’ approach is recommended to build an initial relationship e.g. face-to-face meeting. Phone interaction or video conferencing is a recommended alternative if personal meeting is not possible).

5. Establish clear objectives ~ State your individual expectations and identify common objectives, shared values and outcomes. Find out if the partner’s mission, goals and target market align with your organisation. Evaluate the level of trust between all organisations involved. If your assessment is positive then proceed to next step. If not, assess if mutual trust can be developed. If this is unlikely, go back to step four and research other potential partners.

6. Determine mutual benefit ~ What is the type of benefit ~ economic, productivity, safety, effectiveness or health outcome? Discuss complementary skills, capabilities and resources that are mutually beneficial for the partnership. Evaluate if any training needs are required for both parties during the partnership. Identify what trust behaviours need to be implemented to cement the relationship.

7. Negotiate terms ~ Determine with the partner the roles and responsibilities for partnership coordination and evaluation, product or service development, financial, legal and personnel considerations. Agree on clear measures of success and responsibilities for ongoing communication, implementation, management and evaluation. Consider outcome-based or risk-share agreements, as well as transactional terms.

8. Close the deal ~ Finalise contractual terms, timelines for initiation and sign off. Involve appropriate internal stakeholders for approval and buy-in e.g. legal support, senior executive, etc. Obtain and ensure appropriate leadership support and management resources available to execute the partnership.

9. Communicate and celebrate ~ Disseminate information on the partnership to relevant internal and external stakeholders e.g. local healthcare professionals, community, media, other stakeholders and information or authority gatekeepers.

10. Initiate the partnership with a kick off meeting and/or launch. Set up regular review and evaluation.

I would also like to announce our latest collaboration with Australian Health Insurers, the Customer Retention and Experience White Paper. The Paper will be released soon. If you would like a copy, please visit by first week of May.

About the Author: Dr Avnesh Ratnanesan

Dr Avi is a medical doctor with broad healthcare sector experience including hospitals, biotech, pharmaceuticals and the wellness industry. He is a leading expert who coaches and consults to senior executives, entrepreneurs, practitioners, organisations and governments.