Creating value for participants in multistakeholder alliances: The shifting importance of leadership and collaborative decision-making over time.

BACKGROUND Multistakeholder alliances that bring together diverse organizations to work on health-related issues are playing an increasingly prominent role in the U.S. health care system. Prior research shows that collaborative decision-making and effective leadership are related to members' perceptions of value for their participation in alliances. Yet, we know little about how collaborative decision-making and leadership might matter over time in multistakeholder alliances. PURPOSE The aim of this study was to advance understanding of the role of collaborative decision-making and leadership in individuals' assessments of the benefits and costs of their participation in multistakeholder alliances over time. METHODS We draw on data collected from three rounds of surveys of alliance members (2007-2012) who participated in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. FINDINGS Results from regression analyses indicate that individuals' perceptions of value for their participation in alliances shift over time: Perceived value is higher with collaborative decision-making when alliances are first formed and higher with more effective leadership as time passes after alliance formation. PRACTICE IMPLICATIONS Leaders of multistakeholder alliances may need to vary their behavior over time, shifting their emphasis from inclusive decision-making to task achievement.