IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v144y2015icp112-118.html
   My bibliography  Save this article

Who is on the medical team?: Shifting the boundaries of belonging on the ICU

Author

Listed:
  • Rodriquez, Jason

Abstract

Medical teamwork promises to improve communication and collaboration in the healthcare industry, yet critics argue teamwork is little more than a new managerial discourse to obscure traditional workplace hierarchies. Based on 300 h of participant-observation and 35 interviews with staff of a medical intensive care unit at an academic medical center, this article argues that teamwork is neither a panacea for coordinating complex care nor is it simply a discourse to control workers; rather, it is an ongoing social activity characterized by boundary-work, negotiation, and resistance over the terms of membership. This study identifies three processual and temporal phases of families' participation in medical teams: (1) Constructing Teamwork, (2) Deflection and Resistance, and (3) Reintegration. Staff leveraged ambiguities in the meaning of teamwork to manage patients' family members' participation on the ICU Team. Family involvement changed in patterned ways that reflected the power staff had to define the team and the character of teamwork. Families participated on the team at admission, but their involvement narrowed considerably as staff implemented diagnostic and treatment plans. When staff determined a patient was appropriate for palliation, families were reintegrated back into a leading role on the team as surrogate decision-makers. This study advances current understandings of medical teamwork, staff-family interactions, and it highlights the value of qualitative methods in social-science research about medicine.

Suggested Citation

  • Rodriquez, Jason, 2015. "Who is on the medical team?: Shifting the boundaries of belonging on the ICU," Social Science & Medicine, Elsevier, vol. 144(C), pages 112-118.
  • Handle: RePEc:eee:socmed:v:144:y:2015:i:c:p:112-118
    DOI: 10.1016/j.socscimed.2015.09.014
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953615301192
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2015.09.014?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Finn, Rachael & Learmonth, Mark & Reedy, Patrick, 2010. "Some unintended effects of teamwork in healthcare," Social Science & Medicine, Elsevier, vol. 70(8), pages 1148-1154, April.
    2. Ovretveit, John, 2009. "The contribution of new social science research to patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1780-1783, December.
    3. Kerr, Anne, 2009. "A problem shared...? Teamwork, autonomy and error in assisted conception," Social Science & Medicine, Elsevier, vol. 69(12), pages 1741-1749, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Xyrichis, Andreas & Lowton, Karen & Rafferty, Anne Marie, 2017. "Accomplishing professional jurisdiction in intensive care: An ethnographic study of three units," Social Science & Medicine, Elsevier, vol. 181(C), pages 102-111.
    2. McDougall, A. & Goldszmidt, M. & Kinsella, E.A. & Smith, S. & Lingard, L., 2016. "Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure," Social Science & Medicine, Elsevier, vol. 164(C), pages 108-117.
    3. Liberati, Elisa Giulia & Gorli, Mara & Scaratti, Giuseppe, 2016. "Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care," Social Science & Medicine, Elsevier, vol. 150(C), pages 31-39.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ovretveit, John, 2009. "The contribution of new social science research to patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1780-1783, December.
    2. Martin, Graham P. & Learmonth, Mark, 2012. "A critical account of the rise and spread of ‘leadership’: The case of UK healthcare," Social Science & Medicine, Elsevier, vol. 74(3), pages 281-288.
    3. Sumati Ahuja, 2023. "Professional Identity Threats in Interprofessional Collaborations: A Case of Architects in Professional Service Firms," Journal of Management Studies, Wiley Blackwell, vol. 60(2), pages 428-453, March.
    4. Liberati, Elisa Giulia & Gorli, Mara & Scaratti, Giuseppe, 2016. "Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care," Social Science & Medicine, Elsevier, vol. 150(C), pages 31-39.
    5. Croft, Charlotte & Currie, Graeme, 2020. "Realizing policy aspirations of voluntary sector involvement in integrated care provision: Insights from the English National Health Service," Health Policy, Elsevier, vol. 124(5), pages 549-555.
    6. Glimmerveen, Ludo & Ybema, Sierk & Nies, Henk, 2018. "Empowering citizens or mining resources? The contested domain of citizen engagement in professional care services," Social Science & Medicine, Elsevier, vol. 203(C), pages 1-8.
    7. McDougall, A. & Goldszmidt, M. & Kinsella, E.A. & Smith, S. & Lingard, L., 2016. "Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure," Social Science & Medicine, Elsevier, vol. 164(C), pages 108-117.
    8. Xyrichis, Andreas & Lowton, Karen & Rafferty, Anne Marie, 2017. "Accomplishing professional jurisdiction in intensive care: An ethnographic study of three units," Social Science & Medicine, Elsevier, vol. 181(C), pages 102-111.
    9. Mackintosh, Nicola & Humphrey, Charlotte & Sandall, Jane, 2014. "The habitus of ‘rescue’ and its significance for implementation of rapid response systems in acute health care," Social Science & Medicine, Elsevier, vol. 120(C), pages 233-242.
    10. Iedema, Rick, 2009. "New approaches to researching patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1701-1704, December.
    11. Dahlin, Kristina & Chuang, You-Ta & Roulet, Thomas J, 2018. "Opportunity, Motivation, and Ability to Learn from Failures and Errors: Review, Synthesis, and Ways to Move Forward," SocArXiv 4qwzh, Center for Open Science.
    12. Kendall, Kathleen & Wiles, Rose, 2010. "Resisting blame and managing emotion in general practice: The case of patient suicide," Social Science & Medicine, Elsevier, vol. 70(11), pages 1714-1720, June.
    13. Doherty, Carole & Stavropoulou, Charitini, 2012. "Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review," Social Science & Medicine, Elsevier, vol. 75(2), pages 257-263.
    14. Skyberg, Henriette Lund & Innvaer, Simon, 2020. "Dynamics of interprofessional teamwork: Why three logics are better than one," Social Science & Medicine, Elsevier, vol. 265(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:144:y:2015:i:c:p:112-118. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.