A qualitative study of hospital clinical staff perceptions of their interactions with healthcare middle managers

Abstract

PurposeThe authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.Design/methodology/approachSemi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.FindingsOf 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.Practical implicationsStrategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.Originality/valueThis article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

“…Since the lack of proper interaction between frontline professionals and managerial positions cannot prevent a certain perception of organizational detachment from arising, team autonomy recognition could act as a buffer for professionals who perceive an uncongenial workplace and still channel individuals’ commitment to patient care. 56…”

“…Quite broad evidence has been collected about the factors that enable professionals to interact with management, first of all with regard to the process of learning through feedback exchange and observation of co-workers 43 and frequent collaboration between professional and non-professional managers. 55,56 Although existing research on professional identity have looked at the role of interdependencies of hybrids mainly within their professional community, 1 scholars have recently hihglighted the importance of the interactions between professionals and business managers in the creation of hybrid identities: indeed, interactions occurring in private relational spaces can ease the questioning of the consolidated professional self and allow for identity change 57 and eventually letting go with traditional identities. 49 For instance, Reay et al 57 acknowledged the gap in current literature in which "the importance of interactions between professionals and others has been relegated to the background", showing the potential for change to be orchestrated by others, i.e.…”

“…Since the lack of proper interaction between frontline professionals and managerial positions cannot prevent a certain perception of organizational detachment from arising, team autonomy recognition could act as a buffer for professionals who perceive an uncongenial workplace and still channel individuals' commitment to patient care. 56 Finally, quality and accountability standards can also be leveraged on for legitimacy purposes by specific professional groups: this is the case of those professions engaged in a long "battle for recognition", 86 which could make use of evidencebased practices in order to pursue a dual interest, that of benefiting patients and strengthening legitimacy both for the profession per se and for the managerial status arranged to professionals in the occupational group.…”

Appreciative management from the perspective of healthcare workers in Estonia - a cross-sectional study

“…With structural, functional, and emotional support from managers and colleagues, healthy working conditions are achieved more effectively (Baylina et al, 2018). In particular, interaction between the manager and healthcare workers is seen as the manager reacting to and fulfilling the needs of healthcare workers, whereas disregarding healthcare workers (for example, in the implementation of changes) is regarded as poor interaction (Kendrick et al, 2021).…”