Giving voice to health professionals' attitudes about their clinical service structures in theoretical context.

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dc.contributor.author Braithwaite, J
dc.contributor.author Westbrook, MT
dc.contributor.author Iedema, RA
dc.date.accessioned 2010-05-28T09:50:50Z
dc.date.issued 2005-12
dc.identifier.citation Health care analysis : HCA : journal of health philosophy and policy, 2005, 13 (4), pp. 315 - 335
dc.identifier.issn 1065-3058
dc.identifier.other C1UNSUBMIT en_US
dc.identifier.uri http://hdl.handle.net/10453/9624
dc.description.abstract Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) about their clinical service structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors'. Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights.
dc.format Print
dc.language eng
dc.relation.isbasedon 10.1007/s10728-005-8128-y
dc.title Giving voice to health professionals' attitudes about their clinical service structures in theoretical context.
dc.type Journal Article
dc.parent Health care analysis : HCA : journal of health philosophy and policy
dc.journal.volume 4
dc.journal.volume 13
dc.journal.number 4 en_US
dc.publocation Chichester, UK en_US
dc.identifier.startpage 315 en_US
dc.identifier.endpage 335 en_US
dc.cauo.name FASS.Faculty of Arts and Social Sciences en_US
dc.conference Verified OK en_US
dc.for 2001 Communication and Media Studies
dc.personcode 100638
dc.percentage 100 en_US
dc.classification.name Communication and Media Studies en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords Humans
dc.description.keywords Interprofessional Relations
dc.description.keywords Attitude of Health Personnel
dc.description.keywords Hospital Restructuring
dc.description.keywords Medical Staff, Hospital
dc.description.keywords Personnel, Hospital
dc.description.keywords Organizational Innovation
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group /University of Technology Sydney/Strength - Research in Learning and Change
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10
pubs.consider-herdc false
utslib.collection.history Closed (ID: 3)


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