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The yellow line: a critical study of the symbolic value of artefacts in health care teams

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Abstract

Artefacts reveal an organisation’s “inner life” and they contribute to its image and reputation. They also play a decisive role for an organisation’s development. In this article, similar artefacts from two different health care teams—a trauma team and a psychiatric team—in the same hospital, are compared. The team members were interviewed and their work observed over the course of several years. It was demonstrated that identical pieces of equipment in a trauma team and a psychiatric team signalled opposite values. The psychiatric team was backward-looking, conservative and contradictory. Modern technology and pieces of equipment were associated with an abandoned and previously criticised activity. The corresponding equipment in the trauma team, on the other hand, signalled a forward looking, developing and unified culture. The trauma team was a relatively new and powerfully idealised phenomenon, which attracted attention. The analysis points out how the symbolic values signal that one activity is attractive and pleasing while another has a low external legitimacy.

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References

  • Alchian AA (1958/1977) Some economics of property rights. In: Alchian AA (ed) (1977) Economic forces at work. Liberty Press, Indianapolis

  • Appelbaum SH, Wohl L (2000) Transformation or change: some prescriptions for health care organizations. Manag Serv Qual 10(5):279–298

    Article  Google Scholar 

  • Barker JR (1993) Tightening the iron cage. Concertive control in self-managing teams. Adm Sci Q 38(3):408–437

    Article  Google Scholar 

  • Barner R (2006) Managing complex team interventions. Team Perform Manag 12(1–2):44–54

    Article  MathSciNet  Google Scholar 

  • Berlin J, Carlström E (2008) The 20 minutes team—a critical case study from the emergency room. J Eval Clin Pract 14:569–576

    Article  Google Scholar 

  • Berlin J, Carlström E (2010) From artefact to effect. The organizing effects of artefacts on teams. J Health Organ Manag 24(2) (in press)

  • Bertelsen OW (2000) Design artefacts—toward a design oriented epistemology. Scand J Inf Syst 12(1):15–27

    Google Scholar 

  • Brorström B, Siverbo S (2004) Deeply rooted traditions and the will to change—problematic conflicts in three Swedish health care organizations. J Econ Issues 38(4):939–952

    Google Scholar 

  • Bush PD (1987) The theory of institutional change. J Econ Issues 21(3):1075–1116

    Google Scholar 

  • Czarniawska-Joerges B (1988) Ideological control in nonideological organizations. Praeger Publishers, New York

    Google Scholar 

  • Czarniawska-Joerges B, Joerges B (1990) Linguistic artefacts at service of organizational control. In: Gagliardi Pasquale symbols and artefacts (ed) Views of the corporate landscape. Aldine de Gruyter, New York

    Google Scholar 

  • Dahlborg-Lyckhage E (2003) “Systers” konstruktion och mumifiering—i TV-serier och i studenters föreställningar. Akademisk avhandling. Göteborgs universitet, Göteborg

    Google Scholar 

  • Denison DR (1996) What is the difference between organizational culture and organizational climate? A native’s point of view on a decade of paradigm wars. Acad Manag Rev 21(3):619–654

    Article  Google Scholar 

  • Dewey J (1938/1991) Logic, the theory of enquiry. The later works of John Dewey. Vol 1. In: Boydston JA (ed) Carbondale and Edwardsville: southern Illinois University Press

  • Edmondsson AC (2003) Speaking up in the operating room: how team leaders promote learning in interdisciplinary action teams. J Manag Stud 40(6):1419–1452

    Article  Google Scholar 

  • Flyvbjerg B (2006) Five misunderstandings about case-study research. Qual Inq 12(2):219–245

    Article  Google Scholar 

  • Gagliardi P (1990) Symbols and artefacts. Views of the corporate landscape. Aldine de Gruyter, New York

    Google Scholar 

  • Gersick CJG (1988) Time and transition in work teams: toward a new model of group development. Acad Manag J 31(1):9–41

    Article  Google Scholar 

  • Goffman E (1959) The presentation of self in everyday life. Doubleday & Company, New York

    Google Scholar 

  • Goldman W (2001) Economic grand rounds: is there a shortage of psychiatrists? Psychiatr Surv 52:1587–1589

    Article  Google Scholar 

  • Hatch MJ, Cunliffe AL (2006) Organization theory. Modern, symbolic, and postmodern perspectives. University Press, Oxford

    Google Scholar 

  • Hatch MJ, Schultz M (2002) The dynamics of organizational identity. Hum Relat 55(8):989–1018

    Article  Google Scholar 

  • Jorgensen D (1989) Participant observation. A methodology for human studies. Sage Publications, London

    Google Scholar 

  • Kumar S, Hatcher S, Huggard P (2005) Burnout in psychiatrists: an etiological model. Int J Psychiatry Med 35(4):405–416

    Article  Google Scholar 

  • Kurunmäki L (2004) A hybrid profession—the acquisition of management accounting expertise by medical professionals. Acc Organ Soc 29(3-4):327–347

    Article  Google Scholar 

  • Kurunmäki L, Miller P (2006) Modernising government: the calculating self, hybridisation and performance measurement. Financ Account Manag 22(1):87–106

    Article  Google Scholar 

  • Kvale S (1996) Interviews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks

    Google Scholar 

  • Lewin K (1951) Field theory in social science. Harper & Row, New York

    Google Scholar 

  • Liptzin B (1979) The psychiatrist shortage whats the right number. Arch og Genrela Psychiatr 36(16):1416–1419

    Google Scholar 

  • Mason J (1996) Qualitative researching. Sage Publications, London

    Google Scholar 

  • McSwain EN, Frame S, Paturas LJ (1999) PHTLS.Basic and advanced prehospital trauma life support. Mosby, St. Louis

    Google Scholar 

  • Michie S, West MA (2004) Managing people and performance: a evidence based framework applied to health service organizations. Int J Manag Rev 5(2):91–111

    Article  Google Scholar 

  • Michie S, Williams S (2003) Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med 60:3–9

    Article  Google Scholar 

  • Miettinen R, Virkunnen J (2005) Epistemic objects, artefacts and organizational change. Organization 12(3):437–456

    Article  Google Scholar 

  • Miller A, Xiao Y (2007) Multi-level strategies to achieve resilience for an organisation operating at capacity: a case study at a trauma centre. Cogn Tech Work 9(2):51–66

    Article  Google Scholar 

  • Peters T, Waterman R (1982) In search of excellence: lessons from Americas best run companies. Harper-Row, New York

    Google Scholar 

  • Pfeffer J (1981) Management as symbolic action: the creation and maintenance of organizational paradigms in research in organizational behaviour. In: Cummings LL, Staw BM (eds) pp 1–52. Greenwich. Conn: JAI Press

  • Ragin C (1987) The comparative method: moving beyond qualitative and quantitative strategies. University of California Press, Berkeley

    Google Scholar 

  • Ragin C, Becker H (eds) (1992) What is a case? Exploring the foundations of social inquiry. Cambridge University Press, Cambridge

    Google Scholar 

  • Rheinberger H-J (1997) Toward a history of epistemic things: synthesizing proteins in the test tube. Stanford University Press, Stanford

    Google Scholar 

  • Rose R (1991) Comparing forms of comparative analysis. Polit Stud 39(3):446–462

    Article  Google Scholar 

  • Rozakis M (2007) The cultural context of emergencies. Disaster, Prevention and Management 16(2):201–209

    Article  Google Scholar 

  • Schein EH (1984) Coming to a new awareness of organizational culture. Sloan Management Review 25(1):3–16

    Google Scholar 

  • Schein EH (1992) Organizational culture and leadership. Jossey-Bass, San Francisco

    Google Scholar 

  • Schein EH (1993) How can organizations learn faster? The challenge of entering the green room. Sloan Management Review 34(2):85–93

    Google Scholar 

  • Schneider S, Powerly E (1985) The role of images in changing corporate culture: the case of AT and T. Dragon 1985(2):5–44

    Google Scholar 

  • Shirley P (2000) Providing emergency care in field conditions is a challenging job. British Medical Journal 321:7255–7259

    Article  Google Scholar 

  • Smircich L (1983) Concepts of culture and organizational analysis. Adm Sci Q 28(3):339–358

    Article  Google Scholar 

  • Smircich L, Morgan G (1982) Leadership: the management of meaning. The Journal of Applied Behavioural Science 19(1):3–28

    Google Scholar 

  • Stone D (1997) The doctor as businessman: the changing politics of a cultural icon. J Health Polit Policy Law 22(2):533–556

    Google Scholar 

  • Thorne ML (2000) Cultural Chameleons. Br J Manag 11(4):325–339

    Article  Google Scholar 

  • Tilley H, Tilley IG (1999) External change and its impact on nurse management: a case study. J Nurs Manag 7(1):3–11

    Article  Google Scholar 

  • Van Buskirk W, McGrath D (1999) Organizational cultures as holding environments: a psychodynamic look at organizational symbolism. Human Relations 52(6):805–832

    Google Scholar 

  • Van Maanen J, Barley SR (1984) Occupational communities: culture and control in organizations. In: Staw BM, Cummings LL (eds) Research in organizational behaviour. JAI Press, Greenwich, pp 31–54

    Google Scholar 

  • Van Nieuwaal K (2006) Gas depletion in the Dutch Wadden Sea. Organising paths–paths of organising. Unpublished paper presented at the EISAM Workshop: Organising Paths–Paths of Organising 3rd–4th November in Germany, Berlin

  • Wartofsky MW (1979) Models. Representation and the scientific understanding. Reidel Publishing Company, London

    Google Scholar 

  • Weick KE (1996) Drop your tools: an allegory for organizational studies. Adm Sci Q 41(2):301–313

    Article  Google Scholar 

  • Wenger E (1998) Communities of practice: learning, meaning and identity. Cambridge University Press, Cambridge

    Google Scholar 

  • Wilkins AW, Ouchi WG (1983) Efficient cultures: exploring the relationship between culture and organizational performance. Adm Sci Q 28(3):468–481

    Article  Google Scholar 

  • Xiao Y, Lasome C, Moss J, MacKenzie CF, Faraj S (2001) Cognitive properties of a whiteboard: a case study in a trauma centre. In: Proceedings of the 7th European conference on computer-supported cooperative work, Kluwer Academic Publishers, Bonn, Germany, pp 259–278

  • Xiao Y, Plasters C, Seagull J, Moss JA (2004) Cultural and institutional conditions for high reliability teams. Systems, Man and Cybernetics 3:2580–2585

    Google Scholar 

  • Yin R (1984/1989) Case study research—design and methods. Applied Social Research Methods Series Volume 5. Sage Publications, London

Download references

Acknowledgments

This research study has been sponsored by Vårdalinstitutet, The Swedish Institute for Health Sciences and University West. We are especially grateful to the journal´s editor and three anonymous referees for very useful comments and suggestions to improve the manuscript.

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Authors and Affiliations

  1. Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Vårdalinstitutet, P.O. Box 457, 405 30, Gothenburg, Sweden

    Johan M. Berlin

  2. Department of Nursing, Health and Culture, University West, 461 86, Trollhättan, Sweden

    Eric D. Carlström

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  1. Johan M. Berlin
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  2. Eric D. Carlström
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Correspondence to Johan M. Berlin.

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Berlin, J.M., Carlström, E.D. The yellow line: a critical study of the symbolic value of artefacts in health care teams. Cogn Tech Work 12, 251–261 (2010). https://doi.org/10.1007/s10111-009-0136-5

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