Establishing a multidisciplinary day-care surgery department: Challenges for nursing management

Abstract

Aim To increase our understanding of challenges in implementing multidisciplinary organisational models in hospitals. Background Health‐service policies internationally are pushing for multidisciplinary and patient‐centred organising models but there are challenges involved in moving from profession‐ and discipline‐based organising to the new solutions. Method Qualitative case study, interview and document data collected in real time following the implementation process. Results It was possible to argue for and against the new department applying either a business‐like logic or a professional logic. The respective logics gave different prescriptions for how a hospital department should be organised. Conclusion and Implications for Nursing Management The institutional logics perspective enables managers to understand resistance to new ways of organising work and may be useful in trying to foresee and handle challenges in implementing new organisation models. Managers need to analyse models carefully in terms of which parts may be seen as problematic in their own organisation, and invite all relevant stakeholders into participatory change processes. If the goal is to gather multiple professions and disciplines under one manager in order to increase patient centredness, arrangements must be made for professionals to stay connected to the wider community of practice centred around their specialized knowledge and skills.

Towards a flatter ontology of institutional logics: How logics relate in situations of institutional complexity

“…Healthcare faces similar calls to adopt ‘business‐like’ structures and managerial practices in place of ‘a prevailing professional logic’ (Kitchener, 2002, p. 402). In doing so, government seeks ‘more cost‐efficient and patient‐centred ways of organising health services’ (Øygarden et al., 2019, p. 133) ‘based on efficiency and effectiveness, customer service and business‐like processes’ (Reay & Hinings, 2005, p. 360). Driven by New Public Management (NPM) principles and a public‐good ideology, it stresses ‘rational economic motives’ and introduces ‘practices traditionally found in the corporate sector into public sector organisations’ (Van den Broek et al., 2014, p. 11).…”

Blood Pressure Level in Nurses Who Work in Shifts and Factors Affecting It

“…За даними Øygarden, міжпрофесійна співпраця є ключовим елементом у досягненні більшої інтеграції та задоволенням роботою [14]. Декілька досліджень показують, що така співпраця не досягає бажаного рівня обміну інформацією та знаннями.…”