Negotiating the Crisis

In 1984 Congress revamped Medicare to save a financially distraught health care system, thus transforming the hospital as an organization. Diagnosis Related Groups (DRGs) -- the cornerstone of this extensive reorganization -- have triggered repercussions that are still adversely affecting health care professionals. This volume cuts to the heart of this crisis, examining the difficulties and foibles of going from DRG Legislation to DRG practices and giving voice to the professionals who must carve out a new reality under DRGs. It exposes the disputes between the various professional groups -- administrators, physicians, and nurses --over the implementation of DRGS, and how these professionals maneuver to manage the health service problems created by the policy. The book's authors provide an insightful analysis of the way policy innovations can wreak havoc on an organization and how professionals working together eventually negotiate order out of the chaos of change. The volume's narrative style of research is one feature that makes the presentation of the authors' findings unique from other works on Medicare legislation. Additionally, the book offers a case study approach to communication and sociological matters of a significant health care issue.

Geist, Patricia; Hardesty, Monica

Contents: Preface. Communicating Hospital Order. DRGs: A Revolution in the Financing of Health Care. The Primary Players Negotiating DRG Information. Negotiating Organizational Ideologies. Negotiating Work Roles and Responsibilities. Negotiating Control Relationships in Contested Terrain. Permanence and Change in the Aftermath of DRGs. Researching Hospitals Interpretively. Appendix: Researching Hospitals Interpretively.