PROFESSIONAL CULTURES OF MEDICINE, NURSING, AND HEALTH CARE ADMINISTRATION: A STUDY IN INTERNAL INTEGRATION IN A CHANGING ORGANIZATION.
Contributors: Case Western Reserve University.
Published: 1988
Number of pages: 527
Subjects: Psychology, Industrial.; Sociology, Social Structure and Development.; Health Sciences, General.
Description: Health care organizations are changing rapidly. The subject of this research was the professional's response to organizational change--processes of internal integration addressed within and between professional groups. The professional groups of medicine, nursing, and health care administration were selected for study due to their centrality in a hospital context. The site of the research was a 553 bed general county hospital. The research data were collected from the ambulatory care area of the hospital. Triadic structures of administrative directors, head nurses, and physicians managed the clinics and these management teams uniquely fit the research agenda.

Three research questions guided the inquiry: (1) What characterizes the work cultures of the respective professions of medicine, health care administration, and nursing? (2) How do the professional groups perceive and respond to organizational change according to their cultural frameworks? (3) What is the larger culture of the professional organization, the pattern of the whole, and how does it support the professional cultures?.

Ethnographic research methodologies were used, including interviewing, observation, participant observation, and document review. Data analysis and reduction were iterative; they were ongoing and concomitant with the data collection process.

The cultural dimensions explored in each of the three groups included mission, values and norms, ideology, the impact of change, and interprofessional dynamics. Themes were developed and grouped describing the professional groups' missions, memberships, strengths, rewards, salient concerns, core dilemmas, management of differences, and fears.

Major findings included the following: (1) The professional organization concerns itself with continuity at both the group and organization level; it also attends to the transmission of professional values and knowledge. (2) Professionals primarily identify themselves with their reference groups and secondarily with the organization. Status comparisons between groups are run continuously. (3) Professional groupings tend to create pluralism while the organization as a whole seeks congruence. (4) Mediating and integrating processes coordinate pluralism. (5) Group leaders mediate incongruities between professional groups and the organization. (6) Change in a professional organization must be understood as it transforms core task accomplishment, conceptions of self- and group-preservation, professional values, and professional commitment. Revisiting these issues is an unending process for professionals.
Notes: Source: Dissertation Abstracts International, Volume: 49-04, Section: B, page: 1422.

Thesis (PH.D.)--CASE WESTERN RESERVE UNIVERSITY, 1988.

School code: 0042.