Rick Iedema
Biographic Data
| ID | 117162 |
|---|---|
| NAME | Rick Iedema |
| GIVEN NAMES | Rick |
| FAMILY NAME | Iedema |
| SIGNATURE | IEDEMA R |
| AFFILIATIONS | University of Technology Sydney |
| ORCID | 0000-0001-6792-1048 |
| VERIFIED | Yes |
| TOTAL WORKS | 46 |
| TOTAL CITATIONS | 448 |
| AUTHOR COUNT | 44 |
| EDITOR COUNT | 2 |
| FIRST PUBLICATION YEAR | 1995 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 11 |
Multimodality in Workplaces
In recent times, applied linguistics has broadened its analysis from language to include meaning‐making phenomena other than language.
Affected
Video-reflexive ethnography as potentiation technology
This article has three aims. First, it will set out the ‘potentiating’ premises of video-reflexive ethnography (VRE) and the ways in which VRE potentiates learning through visual feedback as ‘self-irritant’ that invites ‘liminalisation’. Liminalisation invites people to learn by stepping away from their taken-as-given ways of being and saying. Potentiation capitalises on this loosening of identification with what is assumed to be the real, thereb…
To follow a rule? On frontline clinicians' understandings and embodiments of hospital-acquired infection prevention and control rules
This article reports on a study of clinicians' responses to footage of their enactments of infection prevention and control. The study's approach was to elicit clinicians' reflections on and clarifications about the connections among infection control activities and infection control rules, taking into account their awareness, interpretation and in situ application of those rules. The findings of the study are that clinicians responded to footage…
Trajectories of hospital infection control
Video-Reflexive Ethnography in Health Research and Healthcare Improvement
This innovative, practical guide introduces researchers to the use of the video reflexive ethnography in health and health services research. This methodology has enjoyed increasing popularity among researchers internationally and has been inspired by developments across a range of disciplines: ethnography, visual and applied anthropology, medical sociology, health services research, medical and nursing education, adult education, community devel…
The Participatory Zeitgeist
Healthcare systems redesign and service improvement approaches are adopting participatory tools, techniques and mindsets. Participatory methods increasingly used in healthcare improvement coalesce around the concept of coproduction, and related practices of cocreation, codesign and coinnovation. These participatory methods have become the new Zeitgeist-the spirit of our times in quality improvement. The rationale for this new spirit of participat…
Patient Involvement Can Affect Clinicians' Perspectives and Practices of Infection Prevention and Control
This study, set in a mixed, adult surgical ward of a metropolitan teaching hospital in Sydney, Australia, used a novel application of video-reflexive ethnography (VRE) to engage patients and clinicians in an exploration of the practical and relational complexities of patient involvement in infection prevention and control (IPC). This study included individual reflexive sessions with eight patients and six group reflexive sessions with 35 nurses. …
Balancing Opposing Forces-A Nested Process Evaluation Study Protocol for a Stepped Wedge Designed Cluster Randomized Controlled Trial of an Experience Based Codesign Intervention
Background: Process evaluations are essential to understand the contextual, relational, and organizational and system factors of complex interventions. The guidance for developing process evaluations for randomized controlled trials (RCTs) has until recently however, been fairly limited. Method/Design: A nested process evaluation (NPE) was designed and embedded across all stages of a stepped wedge cluster RCT called the CORE study. The aim of the…
Research as Affect-Sphere
This article outlines the main tenets of affect theory and links these to Sloterdijk’s spherology. Where affect foregrounds prepersonal energies and posthuman impulses, spherology provides a lens for considering how humans congregate in constantly reconfiguring socialities in their pursuit of legitimacy and immunity. The article then explores the relevance of “affective spheres” for contemporary social science research. The article’s main argumen…
Finding the patient in patient safety
In the last decade, the field of patient safety has grappled with the complexity of health-care systems by attending to the activity of frontline clinicians. This article extends the field by highlighting the activity of patients and their carers in determining the safety of these systems. We draw on data from three studies exploring patients' accounts of their health-care experiences in Australia and internationally, to show how patients and car…
Medical Discourse
This entry addresses the discourse of contemporary western medicine. Modern western medicine occupies a unique and prominent position among cultures' attempts to defeat illness.
End-of-Life Care in an Acute Care Hospital
The care of people who die in hospitals is often suboptimal. Involving patients in decisions about their care is seen as one way to improve care outcomes. Federal and state government policymakers in Australia are promoting shared decision making in acute care hospitals as a means to improve the quality of end-of-life care. If policy is to be effective, health care professionals who provide hospital care will need to respond to its patient-center…
Discourse studies in the 21st century
This article reflects on some of the definitions and practices that fall under the heading ‘discourse studies’. The springboard for my reflections is Mats Alvesson’s and Dan Kärreman’s retrospective piece, ‘Decolonializing discourse’, published in this issue. In responding to their piece, I’ll address some of the ‘big’ issues they raise: discourse as conceptual frame; discourse as language; the agency of discourse, and discourse as opposed to non…
Disclosing clinical adverse events to patients
Objectives To understand patients’ and health professionals’ experience of Open Disclosure and how practice can inform policy. Background Open Disclosure procedures are being implemented in health services worldwide yet empirical evidence on which to base models of patient–clinician communication and policy development is scant. Design, setting and participants A qualitative method was employed using semi‐structured open‐ended interviews with 154…
Patient perceptions of carrying their own health information
Objective To elicit patients’ views on whether they could contribute to improvements in their care by carrying their own health information to clinician encounters; and to consider the implications for the development of a patient‐held health file (PHF). Background Increasing rates of chronic disease lead to health care being delivered by multiple care providers often at distributed geographic locations. As a way of increasing the availability of…
Multiple Accountabilities in Incident Reporting and Management
In this article, we examine the current and increasing emphasis on accountability and patient safety in health care, focusing on practices of incident reporting and management in New South Wales, Australia. We describe the frames of accountability associated with an incident reporting system, and explore how this system manifests in practice. In contrast to literature that situates incident reporting and local practices as oppositional, we used e…
Discourse and Critical Management Studies
Affect is central to patient safety
New approaches to researching patient safety
A New Structure of Attention
This article presents an inquiry into how clinicians realize a health policy reform initiative called Open Disclosure. Open Disclosure mandates that discussions with patients/family and team staff about "adverse events" are now no longer ad hoc, individualized, and without consequences for how the work is done, but planned, collaborative, and leading to systems change. The article presents an empirical analysis of a corpus of interviews about the…
Practising Open Disclosure
This article explores the way that professionals are being inducted into articulating apologies to consumers of their services, in this case clinicians apologising to patients. The article focuses on the policy of Open Disclosure that is being adopted by health care organisations in the US, Canada, the UK and Australia and other nations. Open Disclosure policy mandates 'open discussion of clinical incidents' with patient victims. In Australia, Op…
Identity Trouble
Identity Trouble assembles contributions from a variety of discourse fields to discuss the pressures on traditional understandings of identity. The focus is on failures and uncertainties in people's c
Identity trouble
Redefining accountability in health care
Conflict in health service delivery is common. It is often attributed to disputes between clinicians and patients or their families about treatment decisions and is particularly common in intensive care units (ICUs), in the form of `futility disputes' between families and medical clinicians about decisions to terminate the active treatment of a dying family member. More common, but less prominent in the literature, is conflict within the medical …
Multimodality, resemiotization
This article has the following two overarching aims. First, it traces the development of multimodal discourse analysis and sets out its main descriptive and analytical parameters; in doing so, the article highlights the specific advantages which the multimodal approach has to offer and exemplifies its application. The article also argues that the hierarchical arrangement of different semiotics (in the way common sense construes this) should not b…
Introduction
This article provides a brief introduction to the other articles in this Special Issue, and sets out some of the traditions in linguistics and discourse analysis which have engaged in organizational research. The article then addresses some of the issues that define organizationality, such as impersonalization, power, and (re)production. The latter of these three is focused on in greater detail and is linked to current concerns with what is now t…
Reshaping ICU Ward Round Practices Using Video-Reflexive Ethnography
In this article, we outline a study method with which structural changes to clinical communication were achieved within a local intensive care unit (ICU). The study method involved in-depth, round-the-clock observation, interviewing, and video filming of how intensivists conducted their practices, as well as showing selected footage to the clinicians for feedback. This feedback component iteratively engaged clinicians in problem-solving their own…
The Participatory Zeitgeist
Healthcare systems redesign and service improvement approaches are adopting participatory tools, techniques and mindsets. Participatory methods increasingly used in healthcare improvement coalesce around the concept of coproduction, and related practices of cocreation, codesign and coinnovation. These participatory methods have become the new Zeitgeist-the spirit of our times in quality improvement. The rationale for this new spirit of participat…
Visibilising clinical work
This paper discusses the role of video-based research methods in social research. The paper situates these methods in the context of rising levels of visibility of professionals in government-funded organisations. The paper argues that while visual research may appear to play an ambiguous role in these organisations, it can also enable practitioners to confront the encroaching demands of post-bureaucratic work. To ground its argument, the paper p…
Formalizing Organizational Meaning
Formality indexes interactional closure: it limits the possibilities for the renegotiation of agreements and decisions. In this article the focus is on how formality is constructed in organizational settings. The article proposes that organizational formalization is achieved on the strength of the recontextualization of meaning from one discourse or practice to another. Importantly, organizational processes of recontextualization tend to increasi…
Research as Affect-Sphere
This article outlines the main tenets of affect theory and links these to Sloterdijk’s spherology. Where affect foregrounds prepersonal energies and posthuman impulses, spherology provides a lens for considering how humans congregate in constantly reconfiguring socialities in their pursuit of legitimacy and immunity. The article then explores the relevance of “affective spheres” for contemporary social science research. The article’s main argumen…
New approaches to researching patient safety
Affect is central to patient safety
What Is Going on
Narrativizing errors of care
Patient Involvement Can Affect Clinicians' Perspectives and Practices of Infection Prevention and Control
This study, set in a mixed, adult surgical ward of a metropolitan teaching hospital in Sydney, Australia, used a novel application of video-reflexive ethnography (VRE) to engage patients and clinicians in an exploration of the practical and relational complexities of patient involvement in infection prevention and control (IPC). This study included individual reflexive sessions with eight patients and six group reflexive sessions with 35 nurses. …
Turning the medical gaze in upon itself
A tale of two hospitals11We draw on the title from Charles Dickens. He opened his famous novel A tale of two cities (London
Discourse studies in the 21st century
This article reflects on some of the definitions and practices that fall under the heading ‘discourse studies’. The springboard for my reflections is Mats Alvesson’s and Dan Kärreman’s retrospective piece, ‘Decolonializing discourse’, published in this issue. In responding to their piece, I’ll address some of the ‘big’ issues they raise: discourse as conceptual frame; discourse as language; the agency of discourse, and discourse as opposed to non…
Video Research in Health
This paper discusses video ethnography as part of a multimethod study of the introduction of information technology to streamline pathology test order entry in hospitals and its effect on the work of pathology laboratory scientists. The paper opens with an overview of video research in health care settings. After acknowledging the limitations inherent in video data, the paper offers a description of how video footage served to enhance insight in …
Finding the patient in patient safety
In the last decade, the field of patient safety has grappled with the complexity of health-care systems by attending to the activity of frontline clinicians. This article extends the field by highlighting the activity of patients and their carers in determining the safety of these systems. We draw on data from three studies exploring patients' accounts of their health-care experiences in Australia and internationally, to show how patients and car…
The (im)possibilities of clinical democracy
In this article, we argue that homogenising discussions of medical dominance on the meta-level of professions do not fully capture the complexity that characterises current clinical care in multidisciplinary health care teams. We illustrate this through an empirical study of a multidisciplinary team attempting to enact their work in a clinically democratic way. The challenges that arose in putting this into practice highlight the depth and comple…
Balancing Opposing Forces-A Nested Process Evaluation Study Protocol for a Stepped Wedge Designed Cluster Randomized Controlled Trial of an Experience Based Codesign Intervention
Background: Process evaluations are essential to understand the contextual, relational, and organizational and system factors of complex interventions. The guidance for developing process evaluations for randomized controlled trials (RCTs) has until recently however, been fairly limited. Method/Design: A nested process evaluation (NPE) was designed and embedded across all stages of a stepped wedge cluster RCT called the CORE study. The aim of the…
A root cause analysis of clinical error
The teleo-affective limits of end-of-life care in the intensive care unit
Institutional Responsibility and Hidden Meanings
This article aims to show how bureaucratic discourses encode and construe the `complicity' and `reciprocal power relations' which theorists like Giddens and Bourdieu see as underpinning and maintaining institutional and hierarchical power. It will address the levels of increasing linguistic complexity and implicitness inherent in bureaucratic texts specifying workers' institutional tasks and responsibilities: job statements, duty descriptions and…
Multiple Accountabilities in Incident Reporting and Management
In this article, we examine the current and increasing emphasis on accountability and patient safety in health care, focusing on practices of incident reporting and management in New South Wales, Australia. We describe the frames of accountability associated with an incident reporting system, and explore how this system manifests in practice. In contrast to literature that situates incident reporting and local practices as oppositional, we used e…
Redefining accountability in health care
Conflict in health service delivery is common. It is often attributed to disputes between clinicians and patients or their families about treatment decisions and is particularly common in intensive care units (ICUs), in the form of `futility disputes' between families and medical clinicians about decisions to terminate the active treatment of a dying family member. More common, but less prominent in the literature, is conflict within the medical …
To follow a rule? On frontline clinicians' understandings and embodiments of hospital-acquired infection prevention and control rules
This article reports on a study of clinicians' responses to footage of their enactments of infection prevention and control. The study's approach was to elicit clinicians' reflections on and clarifications about the connections among infection control activities and infection control rules, taking into account their awareness, interpretation and in situ application of those rules. The findings of the study are that clinicians responded to footage…
Political newsreporting
Institutional Responsibility and Hidden Meanings
This article aims to show how bureaucratic discourses encode and construe the `complicity' and `reciprocal power relations' which theorists like Giddens and Bourdieu see as underpinning and maintaining institutional and hierarchical power. It will address the levels of increasing linguistic complexity and implicitness inherent in bureaucratic texts specifying workers' institutional tasks and responsibilities: job statements, duty descriptions and…
Introduction
This article provides a brief introduction to the other articles in this Special Issue, and sets out some of the traditions in linguistics and discourse analysis which have engaged in organizational research. The article then addresses some of the issues that define organizationality, such as impersonalization, power, and (re)production. The latter of these three is focused on in greater detail and is linked to current concerns with what is now t…
Formalizing Organizational Meaning
Formality indexes interactional closure: it limits the possibilities for the renegotiation of agreements and decisions. In this article the focus is on how formality is constructed in organizational settings. The article proposes that organizational formalization is achieved on the strength of the recontextualization of meaning from one discourse or practice to another. Importantly, organizational processes of recontextualization tend to increasi…
From difference to divergence
This paper considers the tension which develops among participants present at a health planning meeting, and describes the ‘ymbolic violence’ Bourdieu 1991) committed by two speakers on another. The focus will be on the contradiction that arises between bureaucratic discourse which is oriented towards ‘ue process’ and the interpersonalising trend of the talk towards conflict. The paper presents an analysis of around ninety turns of talk, with the…
Resemiotization
The medical record as organizing discourse
This paper analyzes different manifestations of the medical record in order to demonstrate how and why some discourse creates greater organizational reach. In doing so, the paper presents four arguments. First, that types of discourse research that analyze organization from the perspective of regularized practices on the one hand, and those which frame organization as narrative and story-telling unfoldings on the other, are to be complemented wit…
From Doing Work to Talking Work
This paper considers the ways in which work is changing in two very different sites: a gaming machine factory and a metropolitan teaching hospital. In addition, the paper explores the implications of these changes for our own work as researchers and discourse analysts. In comparing the hospital and the factory, and in relating these sites to academia, we aim to bring out commonalities between what is happening to workers in factory occupations an…
Multimodality, resemiotization
This article has the following two overarching aims. First, it traces the development of multimodal discourse analysis and sets out its main descriptive and analytical parameters; in doing so, the article highlights the specific advantages which the multimodal approach has to offer and exemplifies its application. The article also argues that the hierarchical arrangement of different semiotics (in the way common sense construes this) should not b…
Analysing Film and Television
Medical Education and Curriculum Reform
The purpose of this paper is to elaborate criteria by which the principles of curriculum reform can be judged. To this end, the paper presents an overview of standard critiques of medical education and examines the ways medical curriculum reforms have responded to these critiques. The paper then sets out our assessment of these curriculum reforms along three parameters: pedagogy, educational context, and knowledge status. Following on from this e…
A tale of two hospitals11We draw on the title from Charles Dickens. He opened his famous novel A tale of two cities (London
Narrativizing errors of care
The teleo-affective limits of end-of-life care in the intensive care unit
Video Research in Health
This paper discusses video ethnography as part of a multimethod study of the introduction of information technology to streamline pathology test order entry in hospitals and its effect on the work of pathology laboratory scientists. The paper opens with an overview of video research in health care settings. After acknowledging the limitations inherent in video data, the paper offers a description of how video footage served to enhance insight in …
Turning the medical gaze in upon itself
A root cause analysis of clinical error
Visibilising clinical work
This paper discusses the role of video-based research methods in social research. The paper situates these methods in the context of rising levels of visibility of professionals in government-funded organisations. The paper argues that while visual research may appear to play an ambiguous role in these organisations, it can also enable practitioners to confront the encroaching demands of post-bureaucratic work. To ground its argument, the paper p…
The (im)possibilities of clinical democracy
In this article, we argue that homogenising discussions of medical dominance on the meta-level of professions do not fully capture the complexity that characterises current clinical care in multidisciplinary health care teams. We illustrate this through an empirical study of a multidisciplinary team attempting to enact their work in a clinically democratic way. The challenges that arose in putting this into practice highlight the depth and comple…
Identity Trouble
Identity Trouble assembles contributions from a variety of discourse fields to discuss the pressures on traditional understandings of identity. The focus is on failures and uncertainties in people's c
Identity trouble
Redefining accountability in health care
Conflict in health service delivery is common. It is often attributed to disputes between clinicians and patients or their families about treatment decisions and is particularly common in intensive care units (ICUs), in the form of `futility disputes' between families and medical clinicians about decisions to terminate the active treatment of a dying family member. More common, but less prominent in the literature, is conflict within the medical …
Reshaping ICU Ward Round Practices Using Video-Reflexive Ethnography
In this article, we outline a study method with which structural changes to clinical communication were achieved within a local intensive care unit (ICU). The study method involved in-depth, round-the-clock observation, interviewing, and video filming of how intensivists conducted their practices, as well as showing selected footage to the clinicians for feedback. This feedback component iteratively engaged clinicians in problem-solving their own…
What Is Going on
Discourse and Critical Management Studies
Sociology (36 works) · Political science (26 works) · Medicine (23 works) · Psychology (21 works) · Health care (17 works) · Computer Science (16 works) · Law (15 works) · Linguistics (13 works) · Public relations (13 works) · Engineering (12 works)