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There is strength in numbers; there also is risk. While health care associations recognize the advantages of collaborating on matters of common interest, they also are keenly aware it can be fraught with problems. After all, exposing your membership to the benefits offered by other organizations potentially puts your own group’s lifeblood in jeopardy.
Despite the potential risks, however, a number of leading health care associations have been collaborating successfully for years, and that trend appears to be growing. The benefits, many agree, far outweigh the risks.
"Basically, you recognize the expertise and value in another association that’s taken years to create, so rather than recreate that expertise yourself, you look for opportunities to share and trade value," explains Jeanne Boling, MSN, CRRN, CDMS, CCM, executive director of Little Rock, AR-based Case Management Society of America (CMSA). "Other organizations tap into the same type of things with your organization, so it becomes a value for both associations and a tremendous value for the members."
Members will join the association they feel most closely aligned with, she notes, "but no organization can provide virtually everything its members need. You can’t put a lot of money into every subcategory, but if you can identify an organization that really has put a lot of money into developing those resources and has the expertise, and you can connect to part of that expertise, you supplement what you have developed. Your members are extremely well-served, and their loyalty is still to the primary association."
"All of us are in the helping professions," says Anne R. Cox, CAE, executive director of the American Association of Occupational Health Nurses (AAOHN) in Atlanta. "We have to leverage everything we have: resources, expertise, and impact."
"We recognize the other organizations for the specialty they represent, and we respect that," adds Deborah V. DiBenedetto, president of AAOHN. "We’re not the only kid on the block." Keeping membership levels high is a challenge, she admits, and collaboration can help. "It lets our members know we’re here, and it reminds them of the services we provide. Fortunately, our membership has been very stable."
"We’ve been working pretty closely with AAOHN on a number of issues, and in the last couple of years, more closely than we ever had in the past," says Gregory Barranco, director of government relations for the American College of Occupational and Environmental Medicine (ACOEM). "That’s partly because I’m our first on-staff director of government relations, and partly because my AAOHN counterpart Kae Livsey and I get along really well." Barranco is based in Washington, DC.
On some issues, it just makes sense to have a united policy front, he says. "We probably talk every week or so, fill each other in on certain issues. It’s always good to have the two key players in occupational health aligned."
"I’d say that probably in the last six years, we have really begun to collaborate more with other professional associations and government agencies," says Mary Ann Gruden, MSN, CRNP, COHNS/CM, executive president of the American Association of Occupational Health Professionals in Healthcare (AOHP) in Reston, VA. "I think the driver behind that was that we really felt the people out there didn’t know about us. We were a specialty occupational health group, and we wanted to gain recognition as experts in the field." (For a summary description of each of these associations, see "Health care associations," in this issue.)
Gruden says her organization’s increased collaborative efforts are in response to what she sees as a series of new challenges facing health care associations. "These challenges include decreasing support from employers to allow their occupational health providers to be members of associations," she observes. "There may be consolidations involving the elimination of positions, and people also seem to have less time to devote to associations. From an educational standpoint we clearly need to be more collaborative."
One of the oldest collaborations is that of ACOEM and AAOHN, which began nearly 60 years ago with the American Occupational Health Conference (AOHC). "We are two very different organizations within the same business," says DiBenedetto. "But there are common issues of confidentiality, worker health and safety, and so on." The two organizations have issued joint position papers, for example, that appeared on both of their web sites.
"We’ve also had joint ergonomics statements with AOHP," DiBenedetto adds. "We’ve been able to go to its conferences, to start dialogues and find commonalities."
"Our collaboration [with AAOHN] has started very recently," adds Gruden. "As AAOHN president, [DiBenedetto] is very interested in collaborations that are either occupational health-related or affiliated, like case management. We are both primarily occupational health nurses, so our members have a lot of similar needs and concerns: membership, education, competency, keeping abreast of current legislative issues."
Both associations responded to the latest call for comments for the National Forums on Ergonomics. "Even though we didn’t do a joint presentation, we were able to work with Kae Livsey and collaborate on ideas and thoughts, we shared position papers with one another, and saw our similar outlooks and philosophy on positions that should be taken," says Gruden.
Working together with AAOHN in Washington, DC, has benefited Barranco as well. "It provides increased information, an exchange of ideas, and a united front on Capitol Hill or with regulatory agencies," he notes. "We’ve done joint press releases and shared comments on issues like ergonomics."
"It gives us a single voice on things like position papers," DiBenedetto explains. "There might be common lobbying issues, like the [Occupational Safety and Health Administration’s] ergonomics standards. We knew what its issues were, and we could refer to our mutual understandings. In the courts, we have developed amicus briefs for other organizations."
In many cases, associations will have numerous partners. For example, Gruden’s organization collaborated with the Association for Professionals in Infection Control and Epidemiology, as well as with the Joint Commission on Accreditation of Healthcare Organizations, the Centers for Disease Control and Prevention, and OSHA.
"In areas like infection control, there is power in numbers and a lot of opportunities," she explains. "The same is true with our education programs. This year in San Francisco, members of our Northern California chapter presented a specialty workshop on getting started in occupational health care at the AOHC."
Gruden says she’s also looking to develop a task force with members from AAOHN and AOHP to address the growing nursing shortage. AAOHN co-sponsors and endorses other conferences that benefit its members. "For example, we cosponsor CMSA’s conference," she says, "and I attended last year as AAOHN president. We speak at each others’ conferences in an official capacity, sharing information and just trying to get us all out of our silos.’"
AAOHN also has worked quite a bit with the American Nurses Association, says DiBenedetto, as well as OSHA’s Office of Occupational Health Nursing. "Just to be there and to have the same voice on issues like health and safety in the workplace is really important," she says.
Sometimes the collaborations go surprisingly far afield. For example, AAOHN is seeking to invite members of the Society of Human Resources Management to a local program it is sponsoring on telemedicine, and discussing with the National Safety Council the role of the occupational health nurse in managing lost time and disability. (To find out how one health care organization has collaborated with more than 50 partners, see "Not all partners are created equal," in this issue.)
Barranco says ACOEM also partners with the American College of Preventive Medicine (ACPM). "We review each other’s comments before turning them in. In the summer of 2000, we co-signed a comment paper, and we have done that before. Where we couldn’t agree on joint statements or comments, we have cited specific pieces of each other’s documents in our comments and vice versa. For example, we might say, We agree with ACPM in its position that such and such is or is not a good thing.’"
Of course, no two organizations can agree on everything. "We’re still very different organizations with different missions and visions," says DiBenedetto. "Still, if we are going to the same shore, we can take different boats. In recognition of these new market realities, AAOHN recently changed course, adopting a new approach to strategic planning and issuing a new vision statement. (See "Ongoing strategic plan creates future path,'" in this issue.)
"There definitely are issues where we don’t see eye to eye with AAOHN, like scope of practice," notes Barranco. "We have clashed in the past, but that does not stop us from getting together. We both know where our lines are drawn in the sand, and we stay away from them."
Despite the potential risks and occasional pitfalls, collaboration is well worth the effort, says Boling. "What happens on a organizational basis is just remarkable, because rather than competing for member loyalty — which is the traditional way of looking at things — it makes both organizations much stronger, and the members get even more benefits," she declares. "For instance, AAOHN members may be able to access benefits of CMSA members for a negotiated fee, and vice versa. If we can do that, then AAOHN doesn’t have to pay for the development of those resources. The member can choose whether or not to take advantage of the opportunity; it’s a dynamite concept."
DiBenedetto agrees. "We need to look outside ourselves at many groups that may have been seen as competing organizations," she says.
Will this trend continue, or is it just a fad? it depends on the issues of the day, Barranco says. "It’s increased since I’ve come on board, so I imagine it will continue, but it can come in waves also," he says. "Ergonomics will not always be our No. 1 priority, nor will privacy."
Boling, on the other hand, predicts "an explosion" of collaborations as associations begin to grasp the benefits of partnering instead of competing. "Some people are so protective, and it really depends on a relationship of trust being developed," she says. "At the executive and board levels of most organizations, they are so accustomed to competing and being careful when other organizations form that they tend to be cautious about similar, closely related organizations," Boling says. "But there is a way to address it in a very positive manner. Boards and staffs have to grasp that and be able to establish relationships of trust, and that takes time."
Of course, she adds, it depends on your partner. "AAOHN has been incredibly easy to work with because it has leadership that grasps the concept while still being quite protective of its turf — and it has to be," Boling asserts. "It’s a very delicate balance; you have to know what will work for your members and theirs, and watch where the money will flow and know you will build loyalty in your members. AAOHN is not interested in losing any members to us; we are not interested in stealing them, because we recognize their loyalty will be to the organization they feel closest to."
DiBenedetto says that if associations want to continue to succeed and grow, they must consider collaboration as an important strategy.
"If I have something that would help another organization, I don’t mind sharing," she says. "We don’t mind rocking the boat; we are very willing to take risks now. The times demand it."
[For more information, contact:
• Greg Barranco, Director of Government Affairs, American College of Occupational and Environmental Medicine, 1990 M St., N.W., Suite 340, Washington, DC 20036. Telephone: (202) 785-5553. E-mail: firstname.lastname@example.org.
• Mary Ann Gruden, Manager for Employee Health Services, Sewickley Valley Hospital, 720 Blackburn Road, Sewickley, PA 15143-1498. Telephone: (412) 749-7328.
• Deborah V. DiBenedetto, President, American Association of Occupational Health Nurses Inc., 2920 Brandywine Road, Suite 100, Atlanta, GA 30341. Telephone: (770) 455-7757. Fax: (770) 455-7271. World Wide Web: www.aaohn.org.
• Anne R. Cox, Executive Director, American Association of Occupational Health Nurses Inc., 2920 Brandywine Road, Suite 100, Atlanta, GA 30341. Telephone: (770) 455-7757. Fax: (770) 455-7271. World Wide Web: www.aaohn.org.
• Association of Occupational Health Professionals in Healthcare, 11250 Roger Bacon Drive, Suite 8, Reston, VA 20190-5202. Telephone: (800) 362-4347. Fax: (703) 435-4390. E-mail: email@example.com World Wide Web: www.podi.com/aohp.]