Change Talk in Hospital Management Groups

ABSTRACT

Recent national healthcare reforms have resulted in many changes to healthcare organizations. When social realities are enacted in social interactions, changes also occur in communication through discourses. In public hospitals, middle management groups form one important platform for change talk. This study aimed to identify and understand how change talk emerges in management group meetings. Data were collected from 10 hospital meetings, and change-related interactions were explored by analyzing sensemaking and positioning. In the data, change talk took three forms: collaboration, control and confrontation. These forms consisted of change discourses (change as a possibility, concealed change and enforced change) and simultaneously negotiated positions (expert position, power/powerlessness position and cohesion/opposition position). The findings suggest that middle managers use sensemaking power through discourses. Positioning is also of vital importance in directing change talk because it defines the power relations in the change process.

MAD statement

Both collaborative and restrictive ways of talking about change emerge in planned organizational change. The results showed that change talk can generate collaboration, foreground control or produce confrontation. However, collaboration does not occur when talking about collaboration takes place; it requires collaborative change talk that consists of a specific pairing of discourse and position. The current study analysed meeting interaction in hospital management groups. Change was represented as a possibility but also concealed and enforced. Simultaneously, the positions of expert, power/powerless and conflict/cohesion were communicated. Identifying struggling change discourses and understanding how certain positioning acts influence an agency will support the promotion of desirable change.

KEYWORDS:

• Change talk
• hospital
• organizational change
• positioning
• sensemaking

Disclosure Statement

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

Additional information

Funding

This work was supported by Työsuojelurahasto [grant number 112304].

Notes on contributors

Leena Mikkola

Leena Mikkola (Ph.D.) is a Senior Lecturer in Communication at the Department of Language and Communication Studies in University of Jyväskylä, Finland. Her research interests focus on qualitative methods, social interaction in the workplace and leadership, especially in the social and healthcare sector.

Inka Stormi

Inka Stormi (M.A.) works as a Designer of Research Communication at HAMK Häme University of Applied Sciences, Hämeenlinna, Finland. She works with matters of R&D communication and participates in development of HAMK’s research communication. In her graduate studies she has specialized in change communication.