Caught in the middle: The importance of interprofessional communication between healthcare middle managers in hospitals

Abstract

Over the last few decades, new public management reforms have dominated the hospital sectors in a number of European countries. Financial and nonfinancial performance targets have been introduced into most areas of the hospitals in order to stimulate clinical activity and outcome. Performance management has involved challenging tasks for healthcare middle managers due to service complexities and horizontal and vertical lines of accountability. Doctors and nurses are the major professional middle managers, and they are characterized as hybrid managers. The paper argues that interprofessional communication is important for middle managers as mediators between strategic and operational levels in hospitals. The key concept here is interprofessional communication between hybridized professions and how they manage the joint delivery of high-quality healthcare. Two theoretical perspectives of interprofessional communication and performance management are presented and synthesized in a brief discussion on joint leadership to underline the importance of lateral communication in hospitals. The main contribution from this study is the empirical data, which depict the interprofessional differences in communication between groups of middle managers. The doctors are managers by co-working with their colleagues as hybrid managers, whereas nurses tend to become full-time managers and administrators. The study adds knowledge to previous literature as it exemplifies how professionals design their hybrid roles differently to handle competing institutional logics. Consequently, interprofessional communication is an important element in managing clinical performance and patient throughputs.