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.