Interdisciplinary health care groups increasingly face issues related to power and authority in the patient care process. Many of these issues stem from a tension between the historically entrenched hierarchy in health care organizations and the growing pressure of collaborative models of care that require a flattening of this hierarchy, greater mutual respect among disciplines, and more willingness to share power. This project used the framework of text and conversation to explore how groups negotiate this tension through communication. Findings suggest how some groups navigate texts that reinforce the hierarchy alongside texts that challenge it, creating a delicate balance of power that supports collaboration without threatening the position of those at the top of the hierarchy. Other groups primarily use texts that reinforce the hierarchy without consistently using texts that challenge it, which seems to make collaboration more difficult. These findings challenge the idea that equal balance should always be the goal of power sharing in collaborative interdisciplinary groups and offer a more nuanced understanding of how everyday group communication creates and recreates power relationships that impact collaborative care.

跨学科医疗保健团体越来越多地面临与患者护理过程中的权力和权威相关的问题。其中许多问题源于医疗保健组织历史上根深蒂固的等级制度与协作护理模式日益增长的压力之间的紧张关系，这种压力需要扁平化等级制度、学科之间更大的相互尊重以及更愿意分享权力。该项目使用文本和对话的框架来探索团体如何通过沟通来协商这种紧张局势。调查结果表明，一些团体如何在加强层次结构的文本与挑战它的文本之间导航，创造一种微妙的权力平衡，支持协作，而不会威胁层次结构顶部的地位。其他组主要使用加强层次结构的文本，而没有始终使用挑战它的文本，这似乎使协作更加困难。这些发现挑战了平等平衡应该始终是协作跨学科群体中权力分享目标的观点，并提供了对日常群体交流如何创造和重建影响协作护理的权力关系的更细致入微的理解。