Creating Promising Futures Through Social Construction
Pre-conference Workshops: November 9-10, 2016
At The Global Center for Health Innovation
A Taos Institute Conference
In collaboration with the International Institute for Qualitative Methodology
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Health and effective healthcare fundamentally depend on a vast matrix of relationships. Relationships between and among patients, families, physicians, nurses, administrators, educators, insurance adjustors, and other closely associated professionals (e.g. attorneys, social workers, mental health practitioners, clergy), are all included. These relationships largely revolve around the creation and negotiation of meaning. This is obviously the case when hospital staffs must determine who is responsible for what task, and how these responsibilities should be orchestrated to serve the patient. However, in the relationship between physician and patient, the family and the patient, the physician and the nurse, and so on, the challenges of defining the situation, and determining what is reasonable and valuable, are pivotal to the outcomes. And there are also the more profound questions, for example, how to define health and illness, acceptable risk, malpractice, or tolerable pain. As one moves across the matrix of relationships, multiple meanings are prevalent; misunderstandings and tensions are common; negotiation and readjustment are continuous and inescapable.
Concern with the critical place of relationships in healthcare has gained increasing attention over recent years. This is so for healthcare practitioners and scholars alike. In the realm of practice, for example, the movement in narrative medicine has amply demonstrated the importance of narrative understanding in diagnostics, treatment, communication, collaboration, teamwork, and medical education. In many locales, health education is going through a significant transformation, including a growing focus on culture and the community at large. Interprofessional education is increasing and viewed as important in accreditation and attracting the best students. Educational programs are now using patient groups to educate medical students in the patient experience. The concept of “the patient” is also being reconstructed. Patients are becoming increasingly viewed as partners in their health and healthcare, rather than passive recipients of various treatment modalities. Health and healthcare are no longer thought of as a one-way street with healthcare practitioners holding all the knowledge. The “expert” model is becoming the collaborative model. Further, dialogic programs in hospitals now foster a holistic orientation to patients, and ease the flow of communication among staff. The continual evolution of shared electronic records require staff buy-in and cooperation. The collaborative healthcare movement has had a major impact in fostering a team orientation to healing. At the same time, health practitioners reach out to their communities to discuss needs outside the four walls of hospitals. Group practices bring community members into the hospital both for purposes of increasing local knowledge, exchanging solutions, and providing mutual support.
In the scholarly realm, there have been international explorations of the processes by which people negotiate meaning. Much of this inquiry is termed social constructionist, in its emphasis on the ways in which people co-create their realities, rationalities, and values. Initial work was devoted to the social construction of pain, disease, medical knowledge, and the body in various cultures and sub-cultures. This approach does not deny the importance of the biological nature of disease and suffering but highlights the critical importance of shared beliefs and practices. Moreover the idea of social construction emphasizes how disease concepts change and how individuals and organizations can prepare for changing attitudes and beliefs. By stressing cultural factors such emphasis can also help individual and community cultural competence and humility. The scope includes the analysis of doctor-patient conversation, demonstrating, for example, the ways in which patient views were subtly discredited. In these various initiatives, the significance and potentials of qualitative healthcare study was made manifest. Theoretical developments also illuminated inter-dependent processes in meaning making, and demonstrated components differentiating between generative and degenerative dialogue. From this context emerged a range of specific dialogic tools. For example, innovations in mediation, strength based intervention, and collaborative law were set in motion. Foremost among these practices, however, was Appreciative Inquiry, a practice for the collaborative transformation of organizations – big and small. Appreciative Inquiry is now used across a wide range of health-care settings for purposes of increasing solidarity, reducing conflict, synchronizing efforts, and building mutually supported futures.
Mutually supportive, synchronized, and informative relationships have been linked to a range of positive outcomes. Improved patient care, increased satisfaction for both patients and staff, and an increased financial bottom line are among the most prominent. For example, patient expectations and satisfaction are closely related to the clarity and consistency of information provided and trust developed in the staff. Patient care vitally depends on synchrony between physicians and nursing staff. Staff turnover is related to the alignment between the professional goals of staff and the administration of the organization and its leadership. And, relationships between hospitals and community are essential to political and philanthropic support.
Given an array of positive outcomes, we are attempting to bring these two movements – practice based and scholarly – together into a space of mutual sharing, and thus to generate an international conference that will:
1) Foster a common consciousness and understanding of the central role of relational process in all aspects of healthcare.
2) Educate a broad audience in current thinking and practices related to relational process in healthcare and relationship based forms of care.
3) Promote the sharing of theory and practice so as to enrich existing initiatives and foster further innovation.
4) Explore the social construction of various concepts, including disease, well-being, and death.
5) Expand systems thinking in health care.
To these ends, this 2.5-day conference is one that will include a broad range of lectures, workshops, panels, poster sessions, and publication displays. Prominent figures in the various fields will be featured, with concurrent sessions giving voice to a broad range of innovation leaders. Through posters and panels a place will be made for newly emerging initiatives. Following the conference, an edited book of best practices and web-based resources will share the major content of the event with both the many healthcare professions and the public.
Who should attend:
Innovations in Relational, Collaborative, and Appreciative Practices in
Outcomes for Attendees
Outcomes for Potential Sponsors
We welcome inquiries for sponsorship. If you or an organization you work with or know about is interested in becoming a sponsor of the conference, please email Dawn Dole, Executive Director, at [email protected].
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