No one can whistle a symphony: how hospitals design for daily cross-boundary collaboration
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 7 June 2018
Issue publication date: 3 July 2018
Abstract
Purpose
The purpose of this paper is to investigate how and with which mechanisms health care professionals in practice design for collaboration to solve collective hospital tasks, which cross occupational and departmental boundaries.
Design/methodology/approach
An in-depth multiple-case study of five departments across four hospitals facing fast to slow response task requirements was carried out using interviews and observations. The selected cases were revealing as the departments had designed and formalized their daily hospital operations differently to solve collaboration and performance issues.
Findings
Local collaboration across occupational and departmental boundaries requires bundles of behavioral formalization elements (e.g. standardized plans, resource allocation decisions, assigned formal roles, and handoff routines), and liaison devices (e.g. huddles, boards, and physical proximity), which are used in parallel or sequence. The authors label this “designed collaboration bundles.” These bundles supplement the central organizational structures, processes, and support systems less capable of ensuring fluent coordination at the front line.
Practical implications
Health care professionals and hospital managers can consider designing bundles of organizational design features to proactively develop and ensure collaboration capable of solving collective tasks and bridging departmental and occupational silos to improve health care delivery.
Originality/value
This research paper addresses the fundamental organizational challenge of how to achieve efficient collaboration by studying how formal structures and processes are used in combination on the hospital floor, thereby going beyond previous research that studies these mechanisms individually.
Keywords
Acknowledgements
The authors are grateful to the hospital departments and their staff and managers for participating in the research. The research was made possible by an unconditional grant from the Capital Region of Denmark. The viewpoints expressed are those of the authors and they are also responsible for any errors or omissions.
Citation
Prætorius, T., Hasle, P. and Nielsen, A.P. (2018), "No one can whistle a symphony: how hospitals design for daily cross-boundary collaboration", Journal of Health Organization and Management, Vol. 32 No. 4, pp. 618-634. https://doi.org/10.1108/JHOM-10-2017-0265
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited