Doyle M C
Hosp Community Psychiatry. 1977 Jul;28(7):521-5. doi: 10.1176/ps.28.7.521.
A core group of staff hired to open a new community mental health center attempted to employ the concepts of egalitarianism and role-blurring to avoid the rigidity and the strictly hierarchical approach to decision-making that existed in the state hospital where they formerly worked. The new structure permitted no authority figures, and decisions were made by the staff as a group. All staff, including the unit chief--a physician--and the psychologist, social workers, nurses, and attendants, were expected to rotate shifts and interchange jobs. The author discusses the inefficiencies and the lack of direction that resulted, and describes the evolution of a more traditional authoritative structure that enabled staff to proceed toward the goal of quality patient care.
一群受雇开办新社区心理健康中心的核心员工，试图运用平等主义和角色模糊的理念，以避免他们之前工作的州立医院中存在的决策僵化和严格等级制度。新结构不设权威人物，决策由全体员工共同做出。所有员工，包括科室主任（一名医生）、心理学家、社会工作者、护士和护理员，都要轮流值班并互换工作。作者讨论了由此产生的效率低下和缺乏方向的问题，并描述了一种更传统的权威结构的演变，这种结构使员工能够朝着优质患者护理的目标前进。
