The need for collaboration and cooperation in health care delivery is not news. But one of the first requests often made by leaders and others promoting collaborative work in organizations is for a "facilitator course." As the authors developed more knowledge about the real need, they understood that many of the barriers to collaborative work and learning in organizations can be reduced only by the top leaders, not by expert facilitators. The central knowledge that leaders need to support collaborative work is appreciation of work as a system.

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