Across healthcare systems, technology platforms, and design consultancies, a fundamental shift is reshaping how professionals collaborate. Traditional department-based hierarchies are giving way to sophisticated coordination frameworks that integrate diverse expertise around shared outcomes. The University of North Dakota (UND) in the United States is planning a Health Professions Collaborative Facility that will house nearly all health professions under one roof. That’s an architectural statement that collaboration can no longer happen across hallways and organisational charts.
This infrastructural redesign reflects a broader transformation. The traditional model fails increasingly often. You know the one – where collaboration meant escalating decisions through management chains or scheduling cross-departmental meetings.
It doesn’t work when problems require real-time synthesis of multiple specialties. From healthcare systems coordinating life-critical decisions across medical disciplines to global technology platforms enabling distributed work, new coordination architectures are emerging. They focus on outcome-driven integration over departmental boundaries.
These aren’t isolated innovations. Healthcare, technology platforms, and design methodology are converging on similar coordination principles: frameworks that transcend silos, infrastructure that enables integration, and shared methodological approaches that align diverse specialists.
The Multidisciplinary Imperative
Complex professional challenges increasingly exceed single-specialty solutions. That makes multidisciplinary coordination an operational necessity rather than an optional enhancement. This shows up most clearly in healthcare, where integration failures carry immediate clinical consequences. In modern healthcare, a single patient’s care pathway may involve emergency medicine, diagnostic imaging, pathology, surgery, oncology, and rehabilitation. Each brings expertise that must coordinate toward coherent treatment plans.
This isn’t sequential handoff. It’s continuous synthesis where coordination architecture determines clinical outcomes.
Dr Justin S. Brandt, division director of maternal-fetal medicine, illustrates the complexity of real-time adaptive coordination. He notes, “For patients receiving cancer treatment during pregnancy, we provide close monitoring to protect both maternal and fetal health. We track fetal growth and wellbeing throughout treatment with detailed ultrasound assessments and intervene early if any concerns arise. Constant communication among our maternal-fetal medicine, oncology, and surgical teams allows us to adjust care in real time and ensure the best possible outcomes.”
The irony? Healthcare demands ‘constant communication’ between specialists who’ve been trained to think in completely different frameworks. Surgeons focus on precision and immediate intervention. Oncologists think in treatment protocols and long-term survival rates. Maternal-fetal specialists balance two patients simultaneously. Getting them to coordinate isn’t just scheduling. It’s translating between different ways of seeing the same problem.
This describes coordination architecture’s core requirement. You need structured protocols that maintain coherence across diverse expertise while preserving each specialty’s ability to contribute critical judgment as conditions change. The ‘constant communication’ Brandt describes isn’t informal. It’s architected coordination. When coordination architectures fail in healthcare, consequences are immediate and measurable. That makes this domain’s evolution instructive for understanding coordination requirements across professional fields.
Healthcare shows why collaboration can no longer remain incidental.
Coordination as Practised Competency
Effective multidisciplinary coordination requires practitioners who’ve got both specialised technical expertise and sophisticated coordination capability. It’s a dual competency that’s become increasingly fundamental to professional effectiveness across domains.
International clinical projects that combine hospital-based practice with community health initiatives provide structured environments for developing this dual capability. They do this through real-world multidisciplinary collaboration.
Dr Amelia Denniss, an Advanced Trainee physician working within New South Wales health services, provides one example of this approach through her five-week project at Kirakira Hospital in the Solomon Islands. Her work combined hospital-based clinical practice with community health support. This required coordination across local clinical teams, community health workers, and international medical protocols. The project addressed tuberculosis treatment challenges through systematic clinical audit, collaborating with local clinicians to analyse treatment patterns from July 2015 to July 2017.
Conducting rigorous research in resource-limited settings means working with whatever data exists and building trust with local teams who know their context better than any visiting researcher ever will.
That’s coordination capability in practice. The project required synthesising clinical expertise with epidemiological analysis, community health understanding, and resource allocation assessment. Those are coordination capabilities essential for addressing complex health challenges in resource-limited settings. Denniss co-authored the resulting research article “TB or not TB? That is the question regarding TB treatment in a remote provincial hospital in Solomon Islands,” published in Rural and Remote Health in May 2019.
Such international clinical projects show how coordination competence develops through structured multidisciplinary practice. They combine technical clinical skills with the ability to integrate diverse perspectives, work across cultural and professional boundaries, and translate findings into actionable recommendations. While individuals develop these coordination skills through structured practice, the environments and structures they work within either help or hinder that capability development.
Physical Architecture as Coordination Strategy
Physical infrastructure redesigned around integration principles can enable habitual cross-disciplinary interaction. It embeds coordination into professional formation and daily practice rather than treating it as occasional cross-departmental activity.
Infrastructure choices determine coordination feasibility. Organisations can structure physical space to facilitate or impede cross-boundary interaction. The deliberate design of shared spaces represents strategic decisions about what kinds of coordination to enable.
The UND Health Professions Collaborative Facility will house the College of Nursing & Professional Disciplines attached to the existing School of Medicine & Health Sciences. That makes UND one of few universities with nearly all health professions under one roof.
This architectural choice is strategic, not merely convenient.
Physical proximity becomes infrastructure for habitual cross-disciplinary interaction. It embeds coordination into professional formation itself. UND’s facility represents recognition that coordination architecture must be intentional and structured. Physical infrastructure enables coordination through proximity. Digital infrastructure extends that capability across geographic and organisational boundaries.
Digital Platforms Enabling Distributed Coordination
Digital infrastructure creates coordination architectures that transcend geographic and organisational boundaries. It provides structured frameworks for distributed information-sharing and aligned action at a global scale.
Digital platforms enable fundamentally different coordination models. Unlike physical co-location, digital infrastructure can connect distributed participants, structure asynchronous contribution, and enable transparent information-sharing across organisational boundaries. The platform becomes the coordination architecture.
Scott Farquhar, co-founder and co-CEO of Atlassian, works on this approach. Atlassian serves over 200,000 customers globally across various industries including space exploration and healthcare. This reach shows how digital infrastructure can provide coordination frameworks applicable across radically different domains. It suggests effective collaboration platforms solve underlying coordination challenges rather than domain-specific workflows.
Atlassian developed the ‘Product Led Growth’ strategy. They eliminated traditional sales hierarchies by embedding collaboration value directly into the product experience. Essentially, they made the software sell itself by proving its value through use rather than through sales presentations.
That’s a fundamental shift in how enterprise software reaches organisations.
The model eliminated a hierarchical layer by making the product itself show coordination architecture. Atlassian’s Nasdaq listing with a valuation exceeding $76 billion in the United States reflects market recognition that collaboration infrastructure has become essential organisational architecture. Apparently, coordination tools are now worth more than many traditional manufacturing companies. Which says something about where value creation has shifted.
Atlassian shows that infrastructure isn’t a neutral backdrop. It’s a coordination architecture that either enables or prevents effective integration across boundaries. Digital platforms achieve at a global scale what physical facilities like UND’s enable locally: structured frameworks for multidisciplinary interaction.
Methodology as Coordination Framework
Physical and digital infrastructure create the conditions for coordination, but they’re not sufficient alone. Effective multidisciplinary coordination requires methodological frameworks that provide shared problem-solving approaches. These enable diverse specialists to align around human-centred outcomes despite different professional training, evaluation criteria, and communication norms.
Structured methodologies give specialists from different disciplines a common problem-solving language. They can collaborate around shared outcomes because they’ve got shared approaches to understanding problems and evaluating solutions.
Tim Brown, CEO and President of IDEO, works on advancing user-centred design through design thinking since IDEO’s founding in 1991. His influential 2008 Harvard Business Review article identified essential qualities of design thinkers: empathy, integrative thinking, optimism, experimentation, and collaboration. Design thinking isn’t limited to designers but applicable across various fields. It helps break down barriers that hinder collaborative problem-solving.
IDEO operates as a collective of engineers, designers, and others who collaborate through emergent consensus rather than hierarchical command. Brown describes his leadership role as curation and storytelling rather than traditional control. His book ‘Change By Design’ shows application through projects like SSM DePaul Health Center, where IDEO used empathy to enhance patient experiences.
IDEO faces challenges as an expensive consultancy and explores new models including Open IDEO and non-profit initiatives. High-quality coordination frameworks require significant investment, which creates tension between sophisticated methodology and broad accessibility.
That’s the trade-off organisations face when developing coordination capability.
Design thinking shows that effective coordination architecture operates at multiple levels. It’s not just organisational structures or digital tools but shared ways of thinking about and approaching problems.
Implementation Requirements and Cultural Challenges
Implementing coordination architectures requires addressing persistent challenges. You’ve got to develop dual competencies in professionals, manage diverse professional cultures with different communication norms, maintain accountability despite distributed decision-making, and restructure organisational incentives to reward collaborative effectiveness.
Healthcare coordination shows exactly what dual competency means. Clinical professionals need domain expertise while simultaneously pulling together perspectives from multiple medical specialties, communicating across different disciplinary frameworks, and coordinating toward integrated care plans. This pattern extends beyond healthcare: engineers need technical design skills plus the ability to coordinate with user experience designers and product managers. Designers need creative capability plus the ability to integrate engineering constraints and business requirements.
Professional effectiveness increasingly depends on coordination competencies alongside domain expertise.
Managing diverse professional cultures creates another headache. Different disciplines train practitioners in distinct communication styles, decision frameworks, and quality standards. Healthcare professionals learn systematic diagnostic protocols and evidence-based medicine principles. Engineers focus on technical specifications and optimisation metrics. Designers emphasise user empathy and iterative refinement. These differences create coordination friction when specialists work together. IDEO’s emergent consensus model uses shared design thinking methodology to bridge different professional cultures. Healthcare’s governance requirements represent another approach – creating formal protocols that structure cross-specialty coordination.
Accountability without hierarchy presents a significant challenge. Traditional hierarchical structures provided clear accountability chains: decisions escalated through defined management levels with explicit approval authority. Sure, they also created bottlenecks, slowed decision-making, and filtered out crucial information from front-line practitioners. But they were simple to understand and implement. Multidisciplinary coordination distributes decision-making across specialists. Brandt’s maternal-fetal medicine coordination shows this: when clinical outcomes depend on integrated decisions across oncology, surgery, and maternal-fetal medicine, accountability structures must maintain coherence despite distributed decision-making.
Organisational incentive restructuring is crucial. Organisations typically evaluate and reward individual technical performance: clinical outcomes, engineering quality, design innovation. Coordination architectures require rewarding collaborative effectiveness: ability to integrate diverse perspectives, communicate across disciplines, contribute to shared outcomes.
These requirements explain why hierarchical structures persist despite limitations. They’re simpler to implement and evaluate. Multidisciplinary coordination delivers superior outcomes but demands more sophisticated organisational capabilities. Organisations must invest in developing these capabilities deliberately.
Building Coordination Capability
Modern challenges don’t fit neatly into departmental boxes. That’s why we’re seeing a shift from traditional hierarchical structures to coordination frameworks that bring diverse expertise together around specific outcomes. It’s not just about collaboration anymore. It’s about redesigning how organisations actually work.
Look at healthcare’s approach to multidisciplinary coordination. They’ve built both physical and digital infrastructure to support it. They’ve developed methodological frameworks to guide it. This isn’t some healthcare-specific innovation – it’s becoming a professional standard across industries.
Organisations that develop sophisticated coordination capabilities will tackle problems that departmentalised structures simply can’t handle. They’ll do it through effective integration of diverse specialists, not because they’ve got superior individual expertise.
UND’s decision to house health professions under one roof isn’t just facility planning. It’s architectural recognition that collaboration can’t remain accidental – something that happens despite organisational structure rather than because of it.
The real question isn’t whether your organisation needs better coordination. It’s whether you’ll build that capability deliberately or let competitors who do solve the problems you can’t.
