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Redrawing the Boundaries: Conceptualizing Emergency Medicine as a Complex Communication System
Unformatted Document Text:  6 staffing shortages, and micro issues such as employee attitudes and behaviors. In this way, it provides a fruitful vantage point from which to observe emergency department work. Moreover, the organizational communication perspective makes extensive use of two metaphors—System and Culture--in characterizing human behavior (Eisenberg & Goodall, 2001). A systems perspective highlights common handoffs and connections, barriers to information flow, permeability of department and organizational boundaries, and the various interdependencies among different aspects of emergency medicine both within and outside of the ED. In contrast, an organizational culture perspective prompts researchers to listen for commonly repeated vocabulary, themes and stories which may reflect underlying assumptions and values that characterize this hospital (Eisenberg & Riley, 2000). Cultural approaches are also well attuned to the presence of ritual practices, repeated patterns of behaviors that may be uniquely representative of emergency medical care at this institution. The organizational communication perspective conceives of communication not as an activity that occurs in health care organizations, but rather as a process that is constitutive of these institutions (Eisenberg & Goodall, 2001; Giddens, 1980). A close examination of the social interactions that shape the hospital’s system(s) and culture(s) promises to reveal a great deal about why things happen the way they do, and the kinds of actions and interventions that would be most effective in creating change. Gaining a better understanding of

Authors: Eisenberg, Eric., Pynes, Joan. and Baglia, Jay.
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staffing shortages, and micro issues such as employee attitudes and behaviors.
In this way, it provides a fruitful vantage point from which to observe emergency
department work.
Moreover, the organizational communication perspective makes extensive
use of two metaphors—System and Culture--in characterizing human behavior
(Eisenberg & Goodall, 2001). A systems perspective highlights common handoffs
and connections, barriers to information flow, permeability of department and
organizational boundaries, and the various interdependencies among different
aspects of emergency medicine both within and outside of the ED. In contrast,
an organizational culture perspective prompts researchers to listen for
commonly repeated vocabulary, themes and stories which may reflect underlying
assumptions and values that characterize this hospital (Eisenberg & Riley,
2000). Cultural approaches are also well attuned to the presence of ritual
practices, repeated patterns of behaviors that may be uniquely representative of
emergency medical care at this institution.
The organizational communication perspective conceives of communication
not as an activity that occurs in health care organizations, but rather as a
process that is constitutive of these institutions (Eisenberg & Goodall, 2001;
Giddens, 1980). A close examination of the social interactions that shape the
hospital’s system(s) and culture(s) promises to reveal a great deal about why
things happen the way they do, and the kinds of actions and interventions that
would be most effective in creating change. Gaining a better understanding of


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