Addressing organizational change in a hospital department

What is an ethnographer?

An ethnographer is someone who does research using ethnography. Ethnography is a research method from anthropology that involves spending time observing people in their own environments. The ethnographer can choose to participate in the activities going around them (participant-observation) or can simply observe. Either way, the goal is to gain a deep understanding of what people do, why they do it, and how they see the world around them.

We asked

1. How does interprofessional collaboration work in this environment?
2. What is the impact of this major organizational change on interprofessional collaboration?
3. How might we address the negative culture change in the department?

We answered with

Making sense of the data

We used qualitative data analysis software (MAXQDA) to analyze our interview data for common themes. We started out with lots of different themes, but refined them as we continued with analysis.

In our co-creation workshops, we use design thinking methods to make sense of our data. More specifically, these included braindumping and brainwriting to ideate solutions to the culture changes that the staff were facing. We also used affinity diagrams to cluster ideas with a common theme.

Our findings

From our interview and ethnographic data, we learned that people were very unhappy with the organizational change. More specifically, they:

• felt that they had lost their relationships with their team members
• had increased workloads and stress levels
• felt unsure about the future of the department
• felt distrustful of management

Staff turnover increased.

Our co-creation workshops and observations told us that staff wanted:

• an opportunity to mourn the way that things used to be
• more communication with management and with each other
• greater clarification of their roles, especially when they were similar to others in the department
• a clear way for management to measure the impact of the organizational changes on patient care

Sharing our findings

We shared these finding with the department through a presentation. We wanted to update them on what we were doing and give them a chance to ask questions. Our goal here was to build rapport through transparency.

The staff involved in the workshops also shared findings through word-of-mouth.

Impact & Outcomes

Challenges & lessons

Increased stress from the organizational & culture change made people less willing to participate in the research. I learned to address the stress they were dealing with and build rapport by doing informal wellness checks and rotating between participants to reduce how much time I was asking them for.