Management and Collaboration in the Healthcare System: An Interaction Analysis

Abstract

Innovation, streamlining and patient-centered care is increasingly being prioritized in the Danish health care system. Resources are scarce and patient involvement is seen as a necessity to provide high quality healthcare. Many initiatives in improving the healthcare take place locally in hospital departments in collaboration with all the employees. This thesis focuses on how co-creation is practiced in interdisciplinary collaboration with doctors, nurses, and other healthcare professionals. This thesis takes a discursive approach to leadership. Discursive leadership focuses on how leadership is practiced at the microlevel of interaction.
This study is designed as a case study and the empirical data was obtained from 3 different meetings at the department of Nephrology at Herlev University Hospital. The objective of all meetings was to develop or implement different initiatives to improve the care of patients. Participants were nurses, doctors, and a secretary. Voice recordings from the meetings were transcribed and a fine-grained analysis of the interaction occurring between the participants was performed.
This study shows that many interactions during the meetings can be classified as either leadership initiatives in which the participants seek to influence others or interactions that contribute to leadership initiatives. This study shows further how interactions between individuals are not sufficient to collaborate and co-create successfully. Participants require relational skills to interactively influence each other to achieve common goals. Ability to acknowledge and flexibility were recognized as crucial relational skills.
Finally, this thesis shows that the rhetorical strategy to ventriloquize is a common strategy to gain influence. Patients were commonly found to be ventriloquized. Participants ventriloquized patients in such different patterns either specifically or generally that this can be seen as a potential obstacle for interdisciplinary collaboration and co-creation.