This article explores the communication patterns and beliefs of researchers and clinicians working in translational medicine organizations. From an institutional logics' perspective, we conducted this case study using surveys, network analysis, and interviews. Our network analysis revealed that most members had frequent communication with others, showing high connectivity between and within subgroups. Probing the corpus of interview notes and using an iterative approach, we found that basic researchers and clinicians differentially recognized and referred to the logics of care and the logics of science. However, both groups were able to identify some forms of bridged logics. This article contributes to our understanding of the development of robust translational medicine and the use of institutional logics in action.

“Managed care” refers to systems for delivering medical care that attempt to control costs and improve quality by monitoring how clinicians treat illnesses, limiting referrals to specialists, and requiring payors' authorization prior to hospitalization and other specialized treatments. These systems have grown since the 1960s, when the US federal government launched the Medicaid and Medicare programs. The term may be considered a rhetorical ideograph, for it describes an ideology of healthcare organization, operating as a slogan as much as a descriptor. Commonly recognized organizational forms associated with managed care include health maintenance organization, preferred provider organizations, and accountable care organizations. Health and organizational communication researchers have studied how managed care changed the ways that clinicians worked together and communicated with each other. Researchers have also documented how managed care organizations have come to dominate the healthcare landscape of the United States while failing to limit cost increases, compared to other countries. Both clinicians and nurses have expressed various degrees of dissatisfaction with working under managed care rules. Managed care has not facilitated access to care by members of lower socioeconomic groups. The entry discusses future directions for research.

In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US' federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes' roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians' work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.

This study examines the relationships two important participative organisational communication practices, namely employee work participation (EWP) and internal communication adequacy (ICA), and information technology (IT) workers' burnout symptoms. Using a sample of 111 IT workers from an IT company based in the Midwest of the United States, results from multiple regression analyses show that ICA and EWP both play important - albeit different - roles in reducing employees' burnout symptoms. ICA is positively associated with employees' sense of professional efficacy/personal accomplishment and negatively associated with depersonalisation/cynicism. EWP, on the other hand, is negatively associated with emotional exhaustion and cynicism. Essentially, the results of this study suggest that both ICA and EWP constitute important protective factors against burnout, especially among knowledge workers. Based on these results, implications and recommendations for reducing IT workers' burnout and building communicatively healthy workplaces are provided.

This study explores how the dialogue—or lack thereof—between employees’ opinions and organization-wide communications relates to employees’ identification with the organization. Using survey data from a sample of 111 IT workers, we performed cross-level tests to explore how employee voice, the perceived adequacy of organization-wide downward communication, and job satisfaction related to employees’ organizational identification. The results of the hierarchical regression and mediation analyses revealed that higher levels of employee voice were associated with higher levels of organizational identification and fully mediated by job satisfaction. Similarly, higher levels of organization-wide communication adequacy were associated with higher levels of organizational identification and partially mediated by job satisfaction. The findings suggest that inclusive and participative organizational communication practices are most likely to foster organizational identification when they are viewed favorably by employees and positively impact their job experiences.

Give us 5 minutes and we will show you the best book to read today. This is it, the expertise in context that will be your best choice for better reading book. Your five times will not spend wasted by reading this website. You can take the book as a source to make better concept. Referring the books that can be situated with your needs is sometime difficult. But here, this is so easy. You can find the best thing of book that you can read.

Organizational scholars have traditionally used conceptual definitions to classify situational tensions such as dialectics, dilemmas, contradictions, and paradoxes. We propose instead to use organizational members’ reactions to define and distinguish among different forms of tensions. In the present study, we propose a model in which dilemmas vary in terms of press (the sense of urgency that they invoke) and balance (the degree to which both sides of the dilemma are regarded as equally important and urgent). Depending on the degree of press and balance, organizations are predicted to undertake various response strategies. To evaluate this model, we studied a large sample of members’ descriptions of organizational responses to dilemmas in the Dutch crisis response system (N = 149). Results indicated variation in press and balance, and while some participants enacted dilemmas as choices, others enacted dilemmas in ways that acknowledged and tried to address both alternatives.

This chapter proposes to develop a general analytic approach to communication and profession with a specific focus on professionalized occupations in health care. It also develops a communicative conception of professional logic with particular reference to health care. The development of institutional logics scholarship has proceeded without insights from the discipline of communication, and without particular attention to professional communication in health care. The medical professionals use professional logic in reacting to developments in electronic media, also known as eHealth. In the personal realm, profession involves the motives and identities of individuals: typically physicians, nurses, and others of particular occupational status. The interactional realm of communication for professions concerns communication between professionals and their patients. Profession connects the individual physician with multiple realms of communication that ultimately help them see in part why the health care system is so difficult to change.

The article contributes to the study of professions by forwarding a strategy for measuring professional identity guided by institutional logics. We review conceptual and measurement strategies used previously in the study of professional identity to articulate a multidimensional and multilevel approach. The application of institutional logics makes clear the importance of beliefs as well as belonging and attachment in the study of professional identity, and at the same time, the project contributes to institutional logics a more thorough explication of professional identity. Providing an exemplary case, we report a multilevel confirmatory factor analysis of measures of professional identity constructs from a national sample of physicians (n = 887) nested in diverse practice organizations ( J = 488), which demonstrated the empirical independence of belonging, attachment, and beliefs across multiple levels of analysis. We discuss the implications of the approach for important theoretical questions at the intersection of identity, organizations, and institutions (e.g. the 'professional-bureaucratic' conflict and the multiplicity of targets of identification). We also make recommendations for operationalizing a multidimensional, multilevel conceptualization of professional identity.

We conceptualize the roots of cognitive, linguistic, and communicative theories of institutions and outline the promise and potential of a stronger communication focus for institutional theory. In particular, we outline a theoretical approach that puts communication at the heart of theories of institutions, institutional maintenance, and change, and we label this approach communicative institutionalism. We then provide a brief introduction to the set of articles contained in the Special Topic Forum on Communication, Cognition, and Institutions and describe the innovative theorizing of these articles in the direction of communicative theories of institutions. Finally, we sketch a research agenda and further steps and possibilities for theory and research integrating communication and institutions.

Considerable research views group, organizational, and professional identities as theoretically and methodologically similar. This study suggests that these identities are generically different. An explanatory sequential mixed data analysis of survey and interview data collected at an information technology organization ( N = 111 workers) was used to examine the relationships between identities and the experience of burnout and to understand the communicative behaviors associated with types of identity and burnout. Survey data revealed that controlling for communication activity, work group identification was associated with lower depersonalization while professional identification was associated with increased personal accomplishment. No relationship was found between organizational identification and burnout. Semistructured interviews revealed three themes related to identification: (a) Being Yourself in the Work Group, (b) Valuing the Role of the IT Professional, and (c) Othering the Organization. Implications for organizational communication with respect to theorizing and measuring organizational identity are discussed.

INTRODUCTION AND NECESSITY FOR TAXONOMY OF CONSULTATIONS The basis of all consultations is communication between clinicians. Consultation is a “service type provided by a physician whose opinion or advice regarding evaluation or management of a specific problem is requested by another physician or other appropriate source.” Patient safety is a major concern in physician-to-physician communication, with evidence showing that transitions of care, specifically during consultations, are high-risk periods. Effective interpersonal communication is fundamental to safe patient care. It lies at the core of the continuum of care from clinician to clinician, shift to shift, between departments and between hospitals. In the emergency department (ED), there is a high frequency of consultations on a wide spectrum of disease processes and medical conditions facing emergency physicians. Additionally, with the increasing scrutiny of resource use and transfers of care, including consultants in crowded EDs, improving safety during consultations grows increasingly important. Consultations may have a place early in what often becomes a transfer of responsibility for patients, yet they are distinct from handoffs or transfers of care. Like transfers in care, there is no current agreement on the definition of a “standard” consultation between an emergency physician and the wide variety of specialists with whom they regularly consult (M. Cohen, B. Hilligoss, unpublished data, 2010). Consultations vary in type and content within and across EDs. They range from questions to requests for procedural assistance, can occur in person or by telephone, and are performed by various types of providers. According to the National Hospital Ambulatory Medical Care Survey, there were 117 million ED visits in 2007. A recent review found that 20% to 40% of patients admitted from the ED received at least 1 specialist consultation during their ED course. In addition, a recent study showed a 94% increase in the probability that an ED’s patient visit would result in a consultation or referral to a specialist between 1999 and 2009. (

OBJECTIVE To describe experiences of uncertainty and management strategies for staff working with families in a hospital waiting room. SETTING A 288-bed, nonprofit community hospital in a Midwestern city. METHODS Data were collected during individual, semistructured interviews with 3 volunteers, 3 technical staff members, and 1 circulating nurse (n = 7), and during 40 hours of observation in a surgical waiting room. Interview transcripts were analyzed using constant comparative techniques. RESULTS The surgical waiting room represents the intersection of several sources of uncertainty that families experience. Findings also illustrate the ways in which staff manage the uncertainty of families in the waiting room by communicating support. CONCLUSIONS Staff in surgical waiting rooms are responsible for managing family members' uncertainty related to insufficient information. Practically, this study provided some evidence that staff are expected to help manage the uncertainty that is typical in a surgical waiting room, further highlighting the important role of communication in improving family members' experiences.

Institutional messages provide a conceptual and empirical link between the predominantly macro world of institutions and the micro world of organizational communication. The concept of the institutional message is used colloquially but has not been developed theoretically.The conception that emerges from a review of the scholarly and primitive uses is that institutional messages are collations of thoughts that take on lives independent of senders and recipients. They may have the force of rules, spread intentionally or unintentionally via multiple channels to narrow or wider audiences. This essay considers the institutionality of messages in terms of their endurance, reach, encumbency, and intentionality. Institutional messages carry institutional logics—patterns of beliefs and rules. They are collations of thoughts that are intentional, enduring, have a wide reach, and encumber organizational participants to engage in certain behaviors or to take performative responses. It is argued that individuals and organizations develop institutional logics as they make sense of institutional messages. Implications and suggestions for research are included.