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Intergroup communication between hospital doctors: Implications for quality of patient care

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  • Hewett, David G.
  • Watson, Bernadette M.
  • Gallois, Cindy
  • Ward, Michael
  • Leggett, Barbara A.

Abstract

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

Suggested Citation

  • Hewett, David G. & Watson, Bernadette M. & Gallois, Cindy & Ward, Michael & Leggett, Barbara A., 2009. "Intergroup communication between hospital doctors: Implications for quality of patient care," Social Science & Medicine, Elsevier, vol. 69(12), pages 1732-1740, December.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:12:p:1732-1740
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    3. Gifford, Rachel & Molleman, Eric & van der Vaart, Taco, 2024. "It's a jungle out there: Understanding physician payment and its role in group dynamics," Social Science & Medicine, Elsevier, vol. 350(C).
    4. Iedema, Rick, 2009. "New approaches to researching patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1701-1704, December.
    5. Powell, Alison E. & Davies, Huw T.O., 2012. "The struggle to improve patient care in the face of professional boundaries," Social Science & Medicine, Elsevier, vol. 75(5), pages 807-814.
    6. Ovretveit, John, 2009. "The contribution of new social science research to patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1780-1783, December.
    7. Nugus, Peter & Carroll, Katherine & Hewett, David G. & Short, Alison & Forero, Roberto & Braithwaite, Jeffrey, 2010. "Integrated care in the emergency department: A complex adaptive systems perspective," Social Science & Medicine, Elsevier, vol. 71(11), pages 1997-2004, December.
    8. Reiss, Michael & Greene, Carolyn A. & Ford, Julian D., 2017. "Is it time to talk? Understanding specialty child mental healthcare providers' decisions to engage in interdisciplinary communication with pediatricians," Social Science & Medicine, Elsevier, vol. 175(C), pages 66-71.
    9. Lanham, Holly Jordan & Leykum, Luci K. & Taylor, Barbara S. & McCannon, C. Joseph & Lindberg, Curt & Lester, Richard T., 2013. "How complexity science can inform scale-up and spread in health care: Understanding the role of self-organization in variation across local contexts," Social Science & Medicine, Elsevier, vol. 93(C), pages 194-202.
    10. Simon N. Leonard & Deborah Devis & Belinda MacGill & Paul Unsworth & Jill Colton & Sam Fowler, 2023. "Enhancing Empathy for Justice: A Methodology for Expansive Teacher Professional Development through Creative Body-Based Learning," Sustainability, MDPI, vol. 16(1), pages 1-16, December.
    11. Bromley, Elizabeth, 2012. "Building patient-centeredness: Hospital design as an interpretive act," Social Science & Medicine, Elsevier, vol. 75(6), pages 1057-1066.

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