Swift role negotiations: Communicative strategies for enabling rapid role shifts in cross-functional teaming

ABSTRACT

This field study of a hospital emergency department (ED) examined role negotiations among ED care providers in teaming (i.e., the process of bringing individuals in distinct roles to collaborate as a temporary unit). A grounded qualitative analysis revealed that although a prescriptive role structure enables teaming through role-based coordination, ED providers negotiated one another’s role shifts via brief communicative acts to work through novel situations. Whereas role negotiation has traditionally been theorized as individuals’ attempts to (re)shape their roles throughout their organizational membership, this study showed how roles are negotiated in action quickly and as needed to adapt to emergent needs. Based on the findings, we reconceptualized role negotiation as swift communication situated in short-lived moments of collaboration.

KEYWORDS:

• Role negotiations
• collaboration
• temporary teams
• teaming
• high-reliability organizations

Acknowledgements

The authors thank the editor Dr. Paul Schrodt and three anonymous reviewers for thoughtful feedback. They are also grateful to the emergency care providers who agreed to be observed and interviewed for this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 In some articles, such as Edmondson (2012), teaming is described as inherently cross-functional processes, and others emphasize the multidisciplinary nature of teaming by using “cross-boundary teaming” (Edmondson & Harvey, 2018). In this paper, we use “cross-functional teaming” to be consistent with our writing.

2 Putnam and Stohl (1990) proposed the bona fide group perspective, emphasizing the study of intact groups in natural settings to understand the continually changing nature of groups and their embeddedness in context. See Lammers and Krikorian (1997) for how this perspective can be applied to the healthcare context.

3 The physicians who agreed to participate seemed comfortable being shadowed possibly because of their past experience of serving as supervising physicians in this ED’s residency program. The physicians who did not respond to our request might have had concerns about the researchers’ fieldwork interfering with their shifts.

4 We had a 24-hour rule for converting our raw fieldnotes into a formal document. However, on a few occasions, factors such as visit schedule changes, fatigue, and other job responsibilities prevented us from strictly adhering to this rule. Typing and expanding fieldnotes from a single visit took us six hours on average.

5 As Tracy (2012) explains, qualitative researchers often conduct their analyses without focused RQs but (re)construct their RQs during or after their analytic processes; yet, they present their RQs in ways that accord with a deductive writing logic due to publication expectations, as we did in this manuscript.

Additional information

Notes on contributors

DaJung Woo

DaJung Woo (Ph.D., University of California, Santa Barbara) is an Assistant Professor in the Department of Communication at Rutgers University. Her research examines communication, socialization, and collaboration within/between organizations or professional groups.

Laura E. Miller

Laura E. Miller (Ph.D., University of Illinois Urbana-Champaign) is an Associate Professor in the School of Communication Studies at the University of Tennessee, Knoxville. Her research explores how families communicate about health, how patients and clinicians communicate within health care contexts, and how illness-related uncertainty is managed.

Leonard N. Lamsen

Leonard N. Lamsen (M.D., Wayne State University) is an Emergency Physician and Emergency Medicine Fellowship Director at the University of Tennessee Medical Center, an Assistant Professor in the Graduate School of Medicine at the University of Tennessee, and Co-Medical Director at the University of Tennessee Center for Advanced Medical Simulation.