Health and Hospital Communication Research
Alternative approaches to understanding and intervening in care
The Centre for Health Communication does research into health (hospital) organisational processes and communication. The purpose of this research is to enhance the safety and quality of these processes. We conduct team-based research, as well as broader policy-related studies.
A significant part of our work centres on working with frontline staff on how they organise their work through communication and information sharing. Here, we use video and related ethnographic methods to reveal taken-for-granted dimensions of care. We also conduct nation-wide surveys and interview studies. One prominent study centred on Open Disclosure: an apology for and an explanation of why care went wrong offered by clinicians to patients.
Why is it is important to come to terms with the full complexity of clinicians' interactions in hospital spaces?
Interactions in hospital spaces appear complex, interrupted and multi-focal. For many researchers, this is a problem that needs to be resolved, even before the complexities that are at issue here are fully appreciated. These researchers also often regard information technology, pathways or other managerial approaches as the answer to simplifying and 'streamlining' the clinical work. Our research, in contrast, shows that interactive complexity is not always a problem that needs to be resolved and eliminated. Particularly in the context of complex kinds of care, intricate interaction patterns may be unavoidable. Therefore, instead of trying to eradicate complexity, we may need to enable clinical teams to handle such complexity. We know that some teams thrive on complexity, in part because it forms the basis of their intensity of collaboration.
Iedema, Rick et al (2006). Corridor Work: how 'liminal' space can be a focal resource for handling complexities of multi-disciplinary health care, In Proceedings of Apros 11: Asia Pacific Researchers in Organization Studies. Melbourne, Australia, pp. 238-247.
Long Debbi, Iedema Rick & Lee Bonne (2007) Corridor Conversations: Clinical Communication in Casual Spaces. In Iedema Rick (ed) The Discourse of Hospital Communication: Tracing Complexities in Contemporary Health Care Organizations. Basingstoke: Palgrave-Macmillan, pp. 182-200.
What characterizes the communicative dynamics of a well-functioning, multi-disciplinary clinical team?
Our research finds that well-functioning clinical teams:
- sustain intensity of interaction; that is, clinicians are co-present for considerable stretches of time.
- allow uncertainty to be expressed across professional boundaries: clinicians feel that they can express lack of certainty to peers, colleague-professionals, and juniors, and these uncertainties are able to become the focus of 'concerted attention' thanks to a shared affectivity.
- develop new 'structures of attention' (Thrift 2004); clinicians become mindful of the implications of their actions for others (colleagues, patients), and they become able to intervene in their own habits.
Iedema, Rick et al (2006). Visibilising Clinical Work: Video Ethnography in the Contemporary Hospital. Health Sociology Review, 15(2). pp 156-168.
Iedema, Rick et al (2007). Video Research in Health: Visibilising the Normative and Affective Complexities of Contemporary Care. Qualitative Research Journal. 6(2): 15-30.