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Re-structuring the negotiated order of the hospital

机译：重新构建医院的谈判顺序

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Researchers continue to lament the lack of organisational focus in the sociology of health and illness. Although studies have increasingly focused on boundaries between organizations, little such research has focused on the formal boundaries within the hospital itself. Given its dramatic compartmentalisation, and continuing prevalence in health systems, the lack of organisational perspective in hospital research limits insights into the effects (as well as the construction) of the order of health work and care. With a greater emphasis on 'ordering' in the concept of negotiated order, the aim of this study is to examine the manifestation and consequences of the formal boundaries of hospital departments. Fieldwork featured 12 months of ethnography, including formal and informal observations, 80 audio-recorded, semi-structured interviews, and 56 field interviews, in the Emergency Departments (EDs) of two tertiary referral hospitals. Compared with in-patient hospital departments, the ED has limited legitimacy claims of organ-specific knowledge to transfer patients out of the ED. The manifestation of specialised knowledge hierarchies in organisational structures disadvantages patients who are older and who have chronic conditions, underpinning the argument that effects as well as the negotiation of stable organisational orders deserve increased attention in the sociology of health and illness.
机译：研究人员继续哀悼缺乏健康和疾病社会学的组织焦点。虽然研究越来越关注组织之间的界限，但这些研究很少专注于医院内的正规界限。鉴于其戏剧性的隔间，以及卫生系统的持续流行，医院研究中缺乏组织视角限制了健康工作顺序的影响（以及建筑）的见解。在谈判订单的概念中更加强调“订购”，本研究的目的是审查医院部门正式界限的表现和后果。实地工特征在于12个月的民族志，包括正式和非正式的观察，80名音频记录，半结构化访谈，以及两位高级推荐医院的紧急部门（EDS）的56个野外面试。与住院医院部门相比，ED对器官特异性知识的合法性声明有限，以将患者转移到ED中。组织结构中的专业知识等级制度的表现缺点年龄较大的患者，患有慢性病的患者，支撑了效果的论点以及稳定的组织命令的谈判值得增加健康和疾病社会学的关注。

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