The healthcare organization seen as composed of silos: a relevant representation?

Résumé En

Healthcare organizations are often described by the literature as being structured around professional silos. Work would be tightly conducted within each silo, with no real links to other silos, giving the appearance of multiple “worlds”. Our proposal seeks to answer one preliminary but fundamental question: is it relevant to represent healthcare organizations as composed of silos? The question is appropriate as regard as the literature about enclaves and fragmented organizations in the context of healthcare management that we study in this paper. To answer the research question, data were collected based on interviews within the different occupational categories of a healthcare facility. Individuals’ responses were then subjected to statistical treatment to verify the existence of silo-centered logic in the discourse of the different categories of actor (trustees, administrative managers, doctors, caregivers). Our results partially infirm the silo cleavage. More precisely, they make it difficult to support the horizontal cleavage.