Re-structuring the negotiated order of the hospital

Bibliographic Data

ID2249490
AuthorsPeter Nugus (Centre for Medical Education and Department of Family Medicine McGill University Quebec Canada, corresponding author)
Year2019
Volume41
Issue2
Pages378-394
Publication date2019-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12838
PMID30710414
OpenAlexW2913745100
LanguageEN
Citations received9
References cited50

Researchers continue to lament the lack of organisational focus in the sociology of health and illness. Although studies have increasingly focused on boundaries between organizations, little such research has focused on the formal boundaries within the hospital itself. Given its dramatic compartmentalisation, and continuing prevalence in health systems, the lack of organisational perspective in hospital research limits insights into the effects (as well as the construction) of the order of health work and care. With a greater emphasis on 'ordering' in the concept of negotiated order, the aim of this study is to examine the manifestation and consequences of the formal boundaries of hospital departments. Fieldwork featured 12 months of ethnography, including formal and informal observations, 80 audio-recorded, semi-structured interviews, and 56 field interviews, in the Emergency Departments (EDs) of two tertiary referral hospitals. Compared with in-patient hospital departments, the ED has limited legitimacy claims of organ-specific knowledge to transfer patients out of the ED. The manifestation of specialised knowledge hierarchies in organisational structures disadvantages patients who are older and who have chronic conditions, underpinning the argument that effects as well as the negotiation of stable organisational orders deserve increased attention in the sociology of health and illness

Argument (complex analysis · Business · Ethnography · Health care · Legitimacy · Negotiation · Order (exchange · Perspective (graphical · Political science · Public relations · Referral · Social science · Sociology · Education, Healthcare and Sociology Research · Management and Organizational Studies · Medicine · Mental Health and Patient Involvement · Nursing

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