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Redrawing the Boundaries: Conceptualizing Emergency Medicine as a Complex Communication System
Unformatted Document Text:  5 a distance” (Tjora 2000). The present study employs ethnographic methods to explore the social and communicative dynamics of emergency medicine in an urban community hospital in the Southeastern United States. The goal of the study was to gain a richer understanding of the specific nature of the challenges facing emergency departments in a local context, and to use these insights to suggest more effective responses. This study is the result of an interdisciplinary partnership between hospital administration and university faculty drawn from the disciplines of Communication and Public Administration. Traditional interventions—based mainly on employee climate surveys and consultant reports— had confirmed the existence of challenges but did little to expose or address their underlying dynamics. At the outset, the challenges facing this particular emergency department (ED) included flagging employee morale, low patient satisfaction, rising patient complaints, and higher than expected management turnover. A qualitative approach had the potential of providing practical insights that may provide important opportunities for tangible improvement. 7KHRUHWLFDO 3HUVSHFWLYH While many aspects of emergency medicine are worthy of observation, the primary focus of this study was on organizational communication, the social practices and interactions that constitute a given organization. Through an explicit focus on discourse and evolving relationships, this perspective can reveal the dynamic interplay between macro issues such as economic trends and

Authors: Eisenberg, Eric., Pynes, Joan. and Baglia, Jay.
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5
a distance” (Tjora 2000). The present study employs ethnographic methods to
explore the social and communicative dynamics of emergency medicine in an
urban community hospital in the Southeastern United States. The goal of the
study was to gain a richer understanding of the specific nature of the challenges
facing emergency departments in a local context, and to use these insights to
suggest more effective responses.
This study is the result of an interdisciplinary partnership between
hospital administration and university faculty drawn from the disciplines of
Communication and Public Administration. Traditional interventions—based
mainly on employee climate surveys and consultant reports— had confirmed the
existence of challenges but did little to expose or address their underlying
dynamics. At the outset, the challenges facing this particular emergency
department (ED) included flagging employee morale, low patient satisfaction,
rising patient complaints, and higher than expected management turnover. A
qualitative approach had the potential of providing practical insights that may
provide important opportunities for tangible improvement.
7KHRUHWLFDO 3HUVSHFWLYH
While many aspects of emergency medicine are worthy of observation, the
primary focus of this study was on organizational communication, the social
practices and interactions that constitute a given organization. Through an
explicit focus on discourse and evolving relationships, this perspective can reveal
the dynamic interplay between macro issues such as economic trends and


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