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"We decide, you carry it out": A social network analysis of multidisciplinary long-term care teams

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  • Cott, Cheryl

Abstract

The purpose of this study was to describe the structure of multidisciplinary long-term care teams by identifying the pattern of relationships that develop amongst staff as they go about their work. Using a social network analysis approach, team members were classified as occupying the same structural position based on their patterns of relationships with other team members. The analysis was based on the results of a self-administered survey of 93 health care workers on three teams in the same multilevel geriatric care facility in Metropolitan Toronto. A common structure of the teams was identified consisting of two sub-teams: a multiprofessional sub-team and a nursing sub-team, each of which has a different structure indicating differential involvement in different types of teamwork. The multiprofessional sub-team has an "organic" structure and is mainly involved in teamwork that involves decision-making and problem-solving, whereas the nursing sub-team has a "mechanistic" structure and is mainly involved in task oriented work. The findings of this analysis indicate that while teamwork may be increasing the participation in decision-making by health professionals other than medicine, rather than flattening the hierarchical structure throughout the health care division of labour, its effects are limited to a group of higher status professionals. The clearly defined hierarchy remains for the lower status subdisciplines, and "I decide, you carry it out" has simply become "We decide, you carry it out".

Suggested Citation

  • Cott, Cheryl, 1997. ""We decide, you carry it out": A social network analysis of multidisciplinary long-term care teams," Social Science & Medicine, Elsevier, vol. 45(9), pages 1411-1421, November.
  • Handle: RePEc:eee:socmed:v:45:y:1997:i:9:p:1411-1421
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    Cited by:

    1. van Wijngaarden, Jeroen D.H. & de Bont, Antoinette A. & Huijsman, Robbert, 2006. "Learning to cross boundaries: The integration of a health network to deliver seamless care," Health Policy, Elsevier, vol. 79(2-3), pages 203-213, December.
    2. Francesca Grippa, 2014. "Combining different components of intellectual capital within clinical teams," MANAGEMENT CONTROL, FrancoAngeli Editore, vol. 2014(2), pages 95-119.
    3. David J Clarke, 2014. "Nursing practice in stroke rehabilitation: systematic review and meta‐ethnography," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(9-10), pages 1201-1226, May.
    4. Sheaff, Rod & Benson, Lawrence & Farbus, Lou & Schofield, Jill & Mannion, Russell & Reeves, David, 2010. "Network resilience in the face of health system reform," Social Science & Medicine, Elsevier, vol. 70(5), pages 779-786, March.

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