The role of physical design and informal communication

increasing the potential of medication errors. However, the social interaction, while
valuable for the above-mentioned reasons, poses the risk for medication errors when it
occurs in abundance in the med room, as it did on 6N. Designers must ascertain a way
to balance the need for supporting social interaction while at the same time limiting its
potentially negative effect on performance and the quality of care.
The second implication for practice regarding social interaction is that nurse
managers and hospital administrators must redefine the culture of the nursing unit to
include these informal, social interactions as “real work.” Becker (2007b) contends
that if the organization’s perception of “real work” doesn’t include spontaneous,
unplanned, opportunistic communication, then it will leave the organizational resource
of informal knowledge networks untapped.
4.6 Implications for Practice: Value of Observation
On 6N, the data collection period coincided with the arrival of a new nurse
manager. In order to better understand the unit she was about to manage, the new
nurse manager spent time observing 6N and discovered inefficiencies that stood in the
way of the optimal functioning of the unit. According to staff, the changes that were
made after observation had tremendous success, including fewer disruptions for nurses
and doctors, unobstructed sightlines through the core of the unit, and more convenient
access to information for visitors. The practical implication is that observation is a
cheap, simple, and effective method for gaining insight into the operation of the unit
as a system. Existing hospitals that have tight budgets yet are interested in improving
operational efficiency can use observation as a tool to discover problems. Managers
and administrators may very well find that there are simple, relatively inexpensive
solutions to these problems that can have significant positive results, as was the case
on 6N. The idea that increasing operational efficiency is a costly endeavor that
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