Kommunikationskanaler og tværfagligt samarbejde i afdeling N

Mette Lindelof

Student thesis: Master executive thesis


This master thesis deals with communication and interdisciplinary teamwork at the Department of Neurology N61 at University Hospital Zealand, Roskilde, Denmark. The department is responsible for inpatients with neurological disorders and our patient approach is interdisciplinary with focus on diagnostics, treatment, rehabilitation, nursing and prevention. On an ordinary day, many professional groups work in the department, for example doctors, nurses, physiotherapists, occupational therapists, social workers, psychologists and speech educators.
I have been chief physician in charge of the department for 18 months by now. Since joining this position, I have often wondered about the communicative challenges and the lack of interdisciplinary interaction, which is contrary to the stated intent of the hospital.
The aim of the thesis is an in-depth analysis of existing formal internal communication channels of the department including the social media, which in this thesis are regarded as an informal internal communication channel. The scope is to gain insight into the department’s communication challenges, our interdisciplinary collaboration and social constitution.
In my thesis I have conducted a qualitative study based on five quantitative interviews of a strategic sample of employees from different professions. I have condensed data and made displays according to Kvales recommendations on qualitative research. The thesis has several limitations, most importantly a limited amount of data available. A larger study would have provided greater clarity, especially the lack of therapists among the persons interviewed weakens the study.
My main findings are that most formal internal communication channels in the department are used mono-disciplinarily. Oral communication in the form of meetings is appreciated by both doctors and nurses. One of the reasons for the popularity of the meetings may be that meetings provide an opportunity for dialogue in opposition to the written channels, which primarily involves one-way communication.
The communicative constitution in relation to the organizational development in our department was analyzed though Åkerström's organizational theory. My data shows how our organization still displays remnants of the homophonic organization with ranking of professional groups; a structure in which nurses are struggling to achieve professional status. At the same time, elements from the heterophonic organization are seen, e.g. the profession-specific management silos. Due to these profession-specific silos there is no place where the organization is represented in its entirety, which in turn creates problems for a holistic approach and hampers the interdisciplinary cooperation of the employees. Despite a large societal focus on development towards the communication-seeking organization, my analysis does not find empirical evidence that we have yet achieved this in practice.
In the thesis I state that the department's internal written communication channels can be seen though the optics of Weick to be a loosely coupled system, and from this point we can analyze the openings it holds for change. Interdisciplinary cooperation can be influenced by creating positive expectations for the collaboration - for example better narratives - and by promoting socialization processes between the professions. This work is already underway, which the empirical example exemplifies.
According to Weick, socialization is when a network has the same frame of understanding of the tasks to be solved. This can be achieved through education, and here we also have several initiatives in progress. However, the lack of common written communication channels in our department seems to block effective planning and further progress.
A constant variable is an unchangeable factor that blocks a loosely coupled system from evolving. In our communicative constitution, nurses' bulletin boards can be considered a constant variable and as such they are likely to block the nursing group from using other more modern communication channels. The hierarchical structure of the homophonic organization can also be seen as a form of constant variable that blocks the organizational development towards interdisciplinarity.
Another finding in this thesis is that Facebook groups seem to influence our organization by creating a space for dialogue between the employees, if necessary, even without the management involved. This forms the basis for relationships and strengthened social capital in the employee groups. According to interview data there has been resistance against the nurses' closed Facebook group among doctors and management. With this in mind, one must consider whether doctors’ and management's hierarchical approach will interfere with the development of trust and social capital in our organization.
Finally, the I addressed my own learning in the process, and I touch on the future perspectives and change in communication management and strategy that ought to be the consequence of the conclusions in this master's thesis.

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2020
Number of pages37