Where Should Leaders Start When Designing Cross-Department Collaboration?

Most healthcare leaders know cross-department collaboration is needed. They see where gaps exist across professions and services, and they experience the challenges that arise when work moves from one department to another without clear integration. The harder question is not whether collaboration is important. It is where to begin.

Designing interprofessional collaborative practice (IPCP) across departments does not start with a large initiative or a new committee. It begins by identifying where collaboration is already required within the system but not yet intentionally supported.

Start with the patient journey

IPCP already exists within your system. It is just not always intentionally designed. Patients move across professions, departments, and services every day. These transitions are where collaboration is required, whether it is supported or not.

A practical place to begin is by mapping where the patient moves between professions. As a leader, you can start by asking where handoffs occur, where information is repeated, delayed, or lost, and where responsibility shifts from one profession or department to another.

These transition points often reveal where collaboration is needed most. Rather than starting with a new initiative, start by examining one patient journey and identifying where coordination depends on individual effort instead of a shared process. When leaders begin with the patient journey, collaboration becomes anchored in real work rather than abstract goals.

The landmark Institute of Medicine report To Err Is Human found that between 44,000 and 98,000 Americans die each year as a direct result of medical errors, with fragmented handoffs and coordination failures consistently identified as contributing factors. The patient journey is not just a conceptual starting point. It is where the consequences of undesigned collaboration are most visible.

Look for workflow breakdowns, not people problems

Many collaboration challenges are described as communication issues. More often, they are workflow issues. When teams rely on emails, messages, and informal conversations to coordinate care, the system is depending on individual effort rather than structured processes.

As a leader, you can ask where teams are relying on informal communication to move work forward, where communication varies depending on who is working that day, and where expectations are unclear across professions. These are often signs that a workflow has not been intentionally designed to support collaboration. IPCP becomes more consistent when workflows reflect how teams actually need to work together. This is not about asking people to try harder. It is about designing systems that make collaboration easier to do.

Identify opportunities for shared work and start small

In many healthcare settings, work is organized in sequence. One profession completes their portion and the next continues the process. This structure can be effective in some situations. In others, it limits integration and keeps work dependent on handoffs rather than shared understanding.

A practical next step is to identify where work could be shared rather than passed from one profession to another. As a leader, you can begin by asking where work could be co-designed instead of handed off, where multiple professions could contribute to a shared plan of care, and where visibility across roles could reduce duplication or delay.

Leaders do not need to redesign the entire system at once. Start with one patient population, one workflow, or one recurring breakdown. Design one shared process intentionally. Make roles visible. Clarify expectations across professions. Support communication within the workflow, not outside of it. Then expand. Small, intentional design decisions often produce meaningful changes in how teams work together.

What this means for system-level leadership

As I wrote in the companion post When Healthcare Is Designed Around Departments, systems produce the outcomes they are designed to produce. When collaboration is not intentionally designed, variation is expected. When it is structured and supported, coordination becomes more consistent.

Department leadership remains essential. System-level results require leaders to see beyond their own boundaries and begin designing how work connects across them.

Where to go next

If you are newer to interprofessional education (IPE) or IPCP, the earlier posts in this series provide the foundation.

What is Interprofessional Education?

What Interprofessional Education Is Not.

What is Interprofessional Collaborative Practice?

What Interprofessional Collaborative Practice Is Not.

The 6 Conversations That Prepare Teams for System-Level Work is the clearest practical starting point for leaders who are ready to take the next step.

Download the 6 Conversations guide here.

Reach out if you are ready to design collaboration that is supported by structure rather than sustained by personal effort.

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