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List of Figures and Tables | p. xii |
Acknowledgments | p. xiv |
Introduction | p. 1 |
Definitional Issues | p. 2 |
Systems Principles and Evolution | p. 3 |
Systems Approach in Organizational Communication | p. 4 |
Systems Concepts | p. 5 |
Chapter-by-Chapter Summary | p. 11 |
Pedagogical Features | p. 13 |
Summary | p. 13 |
Landscape of Healthcare Delivery | p. 15 |
A Systems Perspective on the Healthcare Environment | p. 16 |
Economic Contingencies | p. 16 |
Social and Demographic Contingencies | p. 19 |
Box 1.1: Communication in Practice: Adapting Successfully to Health System Contingencies | p. 22 |
Models of Health and Illness | p. 23 |
Biomedical and Biopsychosocial Models | p. 34 |
Relationship-Centered Care Model | p. 25 |
Health Organization Contexts | p. 27 |
Healthcare Provider Organizations | p. 27 |
Box 1.2: Communication in Practice: Improving Communication Using a Relationship-Centered Approach | p. 28 |
Public Health Organizations | p. 31 |
Forms of Health Organizing | p. 32 |
Fee-for-Service and Managed Care | p. 33 |
Box 1.3: A Patient's Experience in the Healthcare Landscape | p. 34 |
Communication in the Managed Care Era | p. 37 |
Box 1.4: Ripped from the Headlines: Practicing Medicine in the Managed Care Era | p. 39 |
Chapter Summary | p. 42 |
Organizational Assimilation | p. 43 |
Professions Overview: Trends and Occupations | p. 44 |
A Systems Perspective on Organizational Assimilation | p. 48 |
Conceptualizations of Organizational Assimilation | p. 49 |
Assimilation of Health Professionals | p. 53 |
Assimilation of Medical Professionals | p. 54 |
Box 2.1: Communication in Practice: Building Communication Competence in the Formal Medical Curriculum | p. 56 |
Box 2.2: Ripped from the Headlines: Lessons Learned from the Hidden Curriculum | p. 59 |
Assimilation of Nonmedical Professionals | p. 61 |
Role Communication | p. 63 |
Role Development and Negotiation | p. 63 |
Box 2.3: Communication in Practice: "Best Practice" Role Communication in Health Organizations | p. 66 |
Role Performances and Role Dialectics | p. 67 |
Chapter Summary | p. 69 |
Identity and Power | p. 71 |
A Systems Perspective on Identity and Identification | p. 72 |
Identification | p. 74 |
Identification Messages and Targets | p. 74 |
Box 3.1: Ripped from the Headlines: Identifying with Profession and Team in Health Social Work | p. 77 |
Negotiating Identifications | p. 81 |
Box 3.2: Communication in Practice: Constructing Professional Identity in Healthcare | p. 83 |
A Systems Perspective on Power | p. 85 |
Power in Health Organizations | p. 87 |
Knowledge Power and Disciplinary Power | p. 87 |
Power and Control | p. 89 |
Box 3.3: Communication in Practice: Communicating Powerfully with Others | p. 90 |
Power and Ideology | p. 94 |
Chapter Summary | p. 96 |
Stress, Burnout, and Social Support | p. 98 |
A Systems Perspective on Stress and Burnout | p. 99 |
Sources of Stress in Health Organizations | p. 100 |
Role Stressors | p. 100 |
Box 4.1: Ripped from the Headlines: "Good Grief:" Stress and Social Support in Nursing | p. 103 |
Emotional Labor Stressors | p. 105 |
Organizational Stressors | p. 108 |
Burnout in the Health Professions | p. 111 |
Burnout Dimensions | p. 111 |
Box 4.2: Communication in Practice: Recognizing the Signs of Burnout | p. 113 |
Costs of Burnout | p. 114 |
A Systems Perspective on Social Support | p. 116 |
Characteristics and Sources of Social Support | p. 116 |
Box 4.3: Communication in Practice: Individual and Organizational Coping Strategies | p. 120 |
Social Support Functions and Dysfunctions | p. 121 |
Chapter Summary | p. 122 |
Change and Leadership | p. 124 |
A Systems Perspective on Change | p. 125 |
Understanding Organizational Change | p. 126 |
Models of Organizational Change | p. 126 |
Forms of Health Organization Change | p. 127 |
Managing Planned Change | p. 127 |
Reactions to Change | p. 130 |
Change Communication Processes | p. 132 |
Box 5.1: Communication in Practice: Making Innovation an Organizational Reality | p. 133 |
A Systems Perspective on Leadership | p. 136 |
Leadership Challenges and Theoretical Approaches | p. 137 |
Leadership Challenges | p. 138 |
Box 5.2: Communication in Practice: Leading through Cross-Cultural Respect | p. 139 |
Leadership Approaches | p. 142 |
Box 5.3: Ripped from the Headlines: Leading the Global Movement to End Breast Cancer | p. 145 |
Leaders' Communication Competencies | p. 147 |
Chapter Summary | p. 150 |
Health Teams | p. 151 |
A Systems Perspective on Health Teams | p. 152 |
Health Teams Overview | p. 153 |
Types of Health Teams and Qualities of Clinical Teams | p. 153 |
Teamwork and Health Team Effectiveness | p. 157 |
Team Communication Processes | p. 157 |
Synergistic Communication | p. 158 |
Box 6.1: Communication in Practice: Consensus Decision-Making in Health Teams | p. 162 |
Conflict Communication | p. 163 |
Cultural Diversity in Health Teams | p. 165 |
Profession/Specialization | p. 166 |
Gender and Race/Ethnicity | p. 167 |
Box 6.2: Communication in Practice: How to Get Along in Diverse Health Teams | p. 168 |
Culturally Competent Communication in Health Teams | p. 170 |
Attributes of Cultural Competence and Benefits to Health Teams | p. 171 |
Medical Interpreter-Team Communication | p. 172 |
Box 6.3: Ripped from the Headlines: Connecting Public Health Teams with Communities | p. 176 |
Chapter Summary | p. 177 |
Health Organization Quality | p. 179 |
A Systems Perspective on Quality | p. 180 |
Quality and Health Organization Culture | p. 183 |
Organizational Culture Levels | p. 183 |
Organizational Culture Contributions to Quality Performance | p. 185 |
Box 7.1: Communication in Practice: Developing Culture to Optimize Quality | p. 187 |
Communication and Quality | p. 189 |
Safety | p. 189 |
Box 7.2: Ripped from the Headlines: Enhancing Patient Safety Through Teamwork | p. 193 |
Patient-Centered Care | p. 196 |
Box 7.3: Communication in Practice: Speaking in Plain Language | p. 204 |
Chapter Summary | p. 205 |
Health Communication Technologies | p. 206 |
A Systems Perspective on Health Communication Technologies | p. 207 |
E-health Communication | p. 209 |
Telemedicine | p. 210 |
Electronic Health Records | p. 212 |
Box 8.1: Ripped from the Headlines: Going Paperless at Kaiser Permanente | p. 213 |
Email and Health Organization Websites | p. 215 |
E-health: Transforming Health Organizations | p. 216 |
Changes in Communication Contexts | p. 218 |
Box 8.2: Communication in Practice: Using Email in Patient-Physician Interactions | p. 220 |
Changes in Communication Processes | p. 221 |
Changes in Communication Relationships | p. 223 |
Health Communication Technologies and the Globalization of Public Health | p. 226 |
Global HCT Improvements | p. 226 |
Box 8.3 | p. 230 |
Global HCT Implementation Issues | p. 231 |
Chapter Summary | p. 234 |
References | p. 234 |
Index | p. 266 |
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