TY - JOUR
T1 - Isolation or interaction
T2 - healthcare provider experience of design change
AU - VanHeuvelen, Jane S.
N1 - Publisher Copyright:
© 2019 Foundation for the Sociology of Health & Illness
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/5
Y1 - 2019/5
N2 - Recent studies have drawn attention to the relationship between healthcare environments and patient outcomes. Yet, it remains unclear how changes in the design of healthcare facilities are experienced by providers. To understand this relationship, this study employs an inhabited institutionalist theoretical frame to assess longitudinal ethnographic and interview data collected at a neonatal intensive care unit (NICU) as it transformed from an open-bay unit, to one with single-patient rooms. Findings show that changing the structure of the NICU interfered with the original local organisational culture of collaboration. While providers actively worked to maintain the original culture, their success in doing so was mediated by the built environment. Responding to the new space, practitioners developed new practices. Some of the practices (such as doorway discussions and increased individual assessments) directly undermined the original organisational culture, whereas others (hallway hangouts and calling out) worked to transpose the original culture into the new space. These findings call for greater attention to the effect of physical space on organisational culture.
AB - Recent studies have drawn attention to the relationship between healthcare environments and patient outcomes. Yet, it remains unclear how changes in the design of healthcare facilities are experienced by providers. To understand this relationship, this study employs an inhabited institutionalist theoretical frame to assess longitudinal ethnographic and interview data collected at a neonatal intensive care unit (NICU) as it transformed from an open-bay unit, to one with single-patient rooms. Findings show that changing the structure of the NICU interfered with the original local organisational culture of collaboration. While providers actively worked to maintain the original culture, their success in doing so was mediated by the built environment. Responding to the new space, practitioners developed new practices. Some of the practices (such as doorway discussions and increased individual assessments) directly undermined the original organisational culture, whereas others (hallway hangouts and calling out) worked to transpose the original culture into the new space. These findings call for greater attention to the effect of physical space on organisational culture.
KW - health service organisations
KW - medical practice/medical work
KW - medical/healthcare workforce
KW - teamwork
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U2 - 10.1111/1467-9566.12850
DO - 10.1111/1467-9566.12850
M3 - Article
C2 - 30737809
AN - SCOPUS:85061238571
SN - 0141-9889
VL - 41
SP - 692
EP - 708
JO - Sociology of Health and Illness
JF - Sociology of Health and Illness
IS - 4
ER -