Using ritual to reduce barriers between sub-cultures

Area of Science:

• Healthcare Management
• Organizational Behavior
• Sociology of Professions

Background:

• Demarcation between work groups and professions in the National Health Service (NHS) can lead to dysfunctional consequences.
• Professional and work group autonomy, while important, can be preserved by rituals that maintain negative aspects, hindering progress.

Purpose of the Study:

• To examine the potential for reducing dysfunctional consequences of demarcation in the NHS.
• To explore how interpreting and manipulating rituals can facilitate positive change.
• To identify how new rituals can challenge current practices and promote team-oriented, patient-centered care.

Main Methods:

• A case study hospital was researched extensively to observe rituals.
• Analysis focused on how observed rituals maintain dysfunctional culture norms and behaviors.
• Exploration of new rituals to question existing practices was undertaken.

Main Results:

• Rituals were observed to maintain potentially dysfunctional culture norms and behaviors that resist change.
• These rituals consciously or unconsciously serve to resist moves towards more flexible, team-oriented, patient-centered changes.
• Attention to rituals in the change process can facilitate desired changes.

Conclusions:

• Changes confronting unnecessary demarcation, without undermining professional integrity, can benefit NHS hospitals.
• Interpreting and manipulating rituals offers a pathway to reduce negative professional autonomy and improve patient care.
• Strategic attention to rituals is crucial for successful organizational change in healthcare settings.