THE ORGANIZATIONAL PATHWAYS MODEL: LINKING COMMUNICATION IN HEALTH CARE TO HEALTH IMPROVEMENT

Abstract

Notwithstanding the utility of Street et al.’s (2009) pathways model, it is limited to patient-physician interpersonal communication. Given that most health care is situated within the context of a health care organization, researchers must account for the organizational factors that influence pathway trajectories. To this end, this study advanced a new, organizational pathways model that includes: (1) an emphasis on multiple communicators, (2) communication behaviors, (3) modifiers, (4) organizational-related variables and outcomes. The second part of the study involved testing the new model. A cross-sectional pathway analysis involving 417 patients, 193 nurses, and 74 physicians was conducted. The results showed that (1) the new model adheres to the system theorized by Street et al., (2) organizational factors such as modifiers (respect and time), organizational identity, and collaboration influence health care pathways, and (3) each communicator dyad has its own unique pathway trajectories.