Organizational control through administrative forms: A case study of documentation at a public psychiatric hospital.
Item
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Title
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Organizational control through administrative forms: A case study of documentation at a public psychiatric hospital.
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Identifier
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AAI9820581
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identifier
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9820581
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Creator
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Soll, Edith.
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Contributor
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Adviser: Robert Alford
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Date
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1998
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Language
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English
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Publisher
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City University of New York.
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Subject
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Sociology, Public and Social Welfare | Sociology, Industrial and Labor Relations | Psychology, Clinical | Health Sciences, Health Care Management | Health Sciences, Mental Health
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Abstract
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The impetus for this thesis was the observation that from the mid 1970s to the early 1990s documentation on forms that comprised psychiatric medical records became increasingly central to organizational processes at a public psychiatric hospital. One of the effects of that trend has been a substantial change in the nature of work for members of professions designated to treat psychiatric inpatients, as resources were increasingly allocated toward generating entries in medical records and oversight of those entries.;Precipitants of increased documentation on forms at the psychiatric hospital were noted to be related not only to increased use of forms in the general society but also to the financial and legal pressures that have been affecting public psychiatric services in particular. Unless psychiatric medical records display compliance with a multitude of specifications, regulatory groups, established by entitlement legislation to survey health care facilities, will not release funds on behalf of patients. A by-product of the civil rights movement was legislation that afforded rights for psychiatric patients, including the right to treatment and the right to refuse treatment; substantiation that those rights have been not been violated is expected to be evidenced in patients' records. Wariness about potential litigation induced further concerns about documentation. Uncertain technology and uncertain product extant in psychiatric services are additional factors that have resulted in cumbersome, often stressful documentation processes. Since it is difficult to demonstrate the value of specific staff inputs entries on sanctioned forms are structured to reassure the reader.;Organizations develop forms in reaction to external and internal pressures. Forms are designed, through questions stated and allocation of spaces, to elicit requested data and constrain responses not deemed pertinent. Forms therefore become mechanisms for inculcating organizational ideology. While organizations control documentation output through forms, individuals who must fill them out can be targeted for accountability purposes when they provide required signatures, thus participating in generating their own vulnerabilities for self-incrimination.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
