Brooks Ian, Brown Reva Berman
School of Business and Management, University College Northampton, Northampton, UK.
J Adv Nurs. 2002 May;38(4):341-52. doi: 10.1046/j.1365-2648.2002.02194.x.
The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service Background. One of the ways in which it is possible to achieve successful organizational change is through the elimination of those ceremonies that reinforce or preserve the negative aspects of professional and work group autonomy, thus maintaining the barriers between subcultures. Conversely, the encouraging of ceremonies which reinforce positive aspects is likely to achieve more flexible, team-orientated changes. Aim. The paper considers those ceremonies, which perpetuate barriers in a National Health Service (NHS) Trust, and explores new ceremonies which may question, weaken or eliminate current dysfunctional practices. Design. Our research approach was mainly phenomenological, as we wished to elicit the symbolic significance of organizational routines. The primary source of data was spoken language. The findings are based on purposive sampling of informants by means of semi-structured interview and observation. Other types of information were also collected, including business plans, reports and brochures. Informants included the Chief Executive and four Board members, three consultants, the director of nursing and midwifery, 10 middle managers and eight junior, nonmedical and nonmanagerial employees. Findings. Two broad bands of ceremonies have been identified - those which preserve the existing norms and autonomy of professional and worker groups, which we have named Ceremonies of Preservation, and those which encourage change, which we have called Ceremonies of Change. Considerable data are provided to help to 'tell the story'. Conclusion. The paper argues that attention to ceremonial in the wider change process may facilitate the desired, specific change or changes in practice. It suggests that changes which confront unnecessary demarcation, but which do not undermine professional integrity, can create real benefits for NHS hospitals.
国民医疗服务体系背景下仪式性礼仪在消除亚文化间障碍方面的作用。实现成功组织变革的一种方式是消除那些强化或维持专业及工作群体自主性负面因素的礼仪，从而维持亚文化间的障碍。相反，鼓励强化积极方面的礼仪可能会带来更灵活、以团队为导向的变革。目的。本文探讨了那些在国民医疗服务体系（NHS）信托机构中延续障碍的礼仪，并探索了可能会质疑、削弱或消除当前功能失调做法的新礼仪。设计。我们的研究方法主要是现象学的，因为我们希望引出组织惯例的象征意义。数据的主要来源是口语。研究结果基于通过半结构化访谈和观察对信息提供者进行的目的抽样。还收集了其他类型的信息，包括商业计划、报告和宣传册。信息提供者包括首席执行官和四名董事会成员、三名顾问、护理和助产主任、10名中层管理人员以及八名初级非医疗和非管理员工。研究结果。已识别出两大类礼仪——那些维护专业和工人群体现有规范及自主性的礼仪，我们将其命名为“维护性礼仪”，以及那些鼓励变革的礼仪，我们称之为“变革性礼仪”。提供了大量数据以帮助“讲述故事”。结论。本文认为，在更广泛的变革过程中关注礼仪可能会促进期望的、特定的变革或实践中的变革。它表明，应对不必要界限划分但又不损害专业诚信的变革可为NHS医院带来实际益处。
