TY  - CHAP
AB  - Abstract This article examines how a profit-centered restructuring of labor relations in an academic medical center undermined team-based care practices in its intensive care unit. The Institute of Medicine has promoted team-based care to improve patient outcomes, and the staff in the intensive care unit researched for this paper had established a set of practices they defined as teamwork. After hospital executives rolled out a public relations campaign to promote its culture of teamwork, they restructured its workforce to enhance numerical and functional flexibility in three key ways: implementing a “service line” managerial structure; cutting a range of staff positions while combining others; and doubling the capacity of its profitable and highly regarded intensive care unit. Hospital executives said the restructuring was necessitated by changes to payment models brought forth by the Affordable Care Act. Based on 300 hours of participant-observation and 35 interviews with hospital staff, findings show that the restructuring lowered staff resources and intensified work, which limited their ability to practice care they defined as teamwork and undermined the unit’s collective identity as a team. Findings also show how staff members used teamwork as a sensitizing concept to make sense of what they did at work. The meanings attached to teamwork were anchored to positions in the hospitals’ organizational hierarchy. This paper advances our understanding of he flexible work arrangements in the health care industry and their effects on workers.
VL  - 30
SN  - 978-1-78714-459-0, 978-1-78714-460-6/0277-2833
DO  - 10.1108/S0277-283320170000030006
UR  - https://doi.org/10.1108/S0277-283320170000030006
AU  - Rodriquez Jason
PY  - 2017
Y1  - 2017/01/01
TI  - Doing More with Less: Intensive Care and the Logic of Flexible Teamwork
T2  - Emerging Conceptions of Work, Management and the Labor Market
T3  - Research in the Sociology of Work
PB  - Emerald Publishing Limited
SP  - 117
EP  - 140
Y2  - 2024/04/24
ER  -