Weick’s Model and its Applications to Health Promotion and Communication

by Richmond Austria

In this paper, I decided to critique the article titled “Applying Weick’s model of

organizing to health care and promotion: Highlighting the central role of health

communication” written by Gary L. Kreps from the Department of Communication in

Georgetown Mason University and was published in the Patient Education and

Counseling journal in 2008 (a copy is attached).

I have special preference towards the topic on health communication due to my

professional focus in health improvement, health promotion and health

communications research. With this paper, I will critique and highlight the

communication theory related to health care communication as a field of practice

using the Weick’s model of organizing.

Weick’s Model as a Hallmark of Communicative Science

Weick’s model is considered to be a Hallmark in communicative science due to

meeting several attributes of science. I present three supportive justifications which

make Weick’s model as a way to understand communication as a science applied to

healthcare settings particularly in health promotions.

1. Science uses models to explain aspects of the real world.

Weick’s model is an example of the many scientific models that can be explored

to support that communication is a science. Kreps (2008) highlighted in his article

the Weick’s model of organizing which is considered to be a contemporary scientific

theory that describes the process of organizing as a set of interconnected

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communication processes that are used to resolve uncertain situations for

promoting problem solving, adaptation, and growth. Weick’s model explains the

uncertain situations that organizational actors confront as equivocal information

inputs that are inherent in the many complex situations, problems, and issues

typically confronted within the organization. Similarly, it is a descriptive model that

explains the ways that coordinated communication activities can be used to guide

organized responses to complex situations (Kreps, 2008).

Karl Weick published in 1969 his book-The Social Psychology of Organizing. In

this book, he presented a process-oriented model stressing human interaction as the

central phenomenon of organizing. He reiterated that organizations are in the

process of existing through continual streams of organized human activities. This

involves communication which is the crucial process performed by organization

members to enable ongoing organization and the specific communicative processes

used to accomplish social organization. Hence, Weick’s model of organizing is an

excellent framework for understanding the inherent complexities of many health

care and health promotion situations, as well as a template to guide effective health

communication interventions (Kreps, 2008).

2. Scientific models are tested by making predictions and checking them against

real world data.

Weick’s model is a scientific model based on testing its applications in the

healthcare setting which could represent real world data. For instance, Weick’s

model of organizing challenges the communication practice of healthcare

organizations. This could be done through collective interdependent communication

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and information processing activities that help reduce uncertainty and identify

appropriate responses. This model also suggests that in the process of organizing,

organizational actors are confronted by many complex, difficult, unpredictable, and

equivocal situations. Each of these difficult (equivocal) situations presents unique

information processing problems. Hence, in order to be effective, health care and

health promotion efforts depend on resolving equivocality in responding to complex

situations by establishing reliable and accurate interpretations and advocating

appropriate responses for healthcare actors (Kreps, 2008).

Kreps (2008) also explained that Weick’s model of organizing identifies feedback

loops that allow organization members such as healthcare actors to maintain a

homeostatic balance in organizing processes. Hence, the systems issues of hierarchy

and interdependence are critical issues for health care and health promotion efforts

where there are multiple interdependent hierarchical levels of social organization.

3. Science uses controlled experiments to test models.

Weick’s model as a hallmark in communication science has been tested in

healthcare organizations. The article of Kreps (2008) illustrated 3 cases which used

Weick’s model to test this model in controlled experiments such as research

programs in healthcare improvement science.

A. The first case was about a nurse retention intervention program. From the

perspective of Weick’s model of organizing, the hospital’s recruitment strategy was

ineffective because it violated the principle of requisite variety. The hospital was

instituting simple rule-based solutions such as recruiting new nurses instead of

exploring the complex problems such as why were nurses leaving. A multi-phase

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research program was implemented to gather information from the nursing staff

about the specific problems they were facing. The retention committee served as an

important two-way communication link between the nursing staff and hospital

administration. Moreover, it provided the nurses at the hospital with a powerful

communication channel to cite their concerns and suggest new directions for

hospital policy. It also provided the hospital administration with valuable information

about hospital problems and solutions of which only nurses might be aware (Kreps,

2008).

B. In the second case, Kreps (2008) presented the dangers of bio-terrorism and

infectious diseases particularly antrax. For instance, one such health crisis occurred

in October 2001 when anthrax spores were spread via the US postal system. This

health communication breakdown could have been avoided by using Weick’s model

of organizing to guide effective crisis communication. The principle of requisite

variety suggests that in a situation of high equivocality, like this, there should be

concerted efforts to gather relevant information through the use of communication

cycles to clearly make sense of the problem (enactment) and to develop appropriate

strategies for responding to the problem.

C. In the third case, the promotion of medication adherence among consumers with

chronic health problems was presented. Based on data gathered about consumer

concerns, communication strategies were developed to help consumers who are

having problems with adherence to register and reduce the levels of equivocality

they are facing concerning their prescribed medications (enactment), identify good

personal strategies for implementing medication adherence into their lives

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(selection), and preserve this information to guide them in future situations when

they are prescribed medications (retention). Prescription drug adherence promotion

is an example of a complex health issue that demands sophisticated evidence-based

communication intervention programs (requisite variety) that can be delivered

over-time through multiple channels to change often-resistant and entrenched

consumer health behaviors (Kreps, 2008).

Weick’s Model as a Communication Theory for Health Promotion

Kreps (2008) showed in his article the application of communicative model such

as Weick’s model in the theory and practice of health promotion and communication.

Weick’s model describes the way that human beings coordinate efforts to process

equivocal information and direct organizational activities. In particular, Weick’s

model of organizing suggests the following seven basic recommendations for health

care promotion providers and consumers:

A. They should engage in regular communication contact with organizational

boundary spanners and environmental representatives for identifying key issues and

processing equivocal information inputs.

B. To remain viable and efficient, they must process information with the same

degree of equivocality as is present in the issue being handed. If they handle

equivocal inputs as though they were unequivocal (without constructing appropriate

communication behavior cycles, fatal mistakes are likely to occur because they will

be unlikely to process the equivocal information into understandable information

and will probably react inappropriately to the inputs. If they handle unequivocal

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inputs as though they were equivocal (by performing a variety of double interacts),

they are likely to waste organizational energy.

C. They must endeavor to accurately register the level of equivocality in information

inputs, construct appropriate communication behavior cycles in response to the

inputs, and process the equivocal inputs into desired organizational outputs. For this,

care must be taken to evaluate information inputs accurately.

D. They can facilitate organizational adaptation to informational equivocality by

making connections throughout the health care system and its relevant environment

and engaging in interaction with key individuals (information sources) on difficult

tasks. Health care consumers and providers must ask relevant questions when

processing difficult information inputs, and work with others to deal with issues that

are too complex for them to individually comprehend and perform easily.

E. They should concentrate less on individual actions and more on the interlocked

communication behaviors of interdependent groups of organizational members

because the process of control within health care systems is accomplished through

relationships among individuals rather than by individuals.

F. Training programs can be developed in health care organizations stressing

teamwork; daily and weekly meetings among organization members can be arranged;

problem-solving and social support groups can be formed to provide the interlocked

communication behaviors necessary for adaptation.

G. Care must be taken to retain relevant information from the ways health care and

health promotion situations have been handled in the past to use as organizational

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intelligence for guiding future efforts. Every previous health care and health

promotion activity provides a precedent and is a point of comparison for future

activities.

Weick’s Model and its Orientation towards Cybernetic Perspective of

Communication

Weick’s model is built on three primary theoretical foundations: sociocultural

evolutionary theory, information theory, and systems theory. Sociocultural

evolutionary theory describes the processes by which people adapt to changes in

their social and cultural environments to survive. Information theory is concerned

with the efficiency of message transmission and reduction of information loss based

on the structural relationships between message codes and channel capacities.

Lastly, systems theory attempts to explain complex organizational processes with

different interdependent hierarchical levels of complexity which include the system,

the subsystem, and the supra-system (Kreps, 2008).

In the previous topics, cybernetics have been highly emphasized. It represents

one of the eight communicative perspectives cited by Craig. A central part of Weick’s

model is the role of information as the key component of organizational

environments. The concept of information environment is a shift from the traditional

structural, static view of physical surroundings to an interactional, process view of

the messages that organization members perceive and the meanings that they

create in response to these messages. Health care system participants rely on a

variety of sources of information in organizing, including interviews, computerized

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records, letters, documents, telephone conversations, group discussions, and

multiple media channels (Kreps, 2008).

Weick’s model of organizing is the concept of information equivocality.

Equivocality is the level of understandability of messages to which organization

members respond. This involves aspects of equivocality which include the levels of

ambiguity, complexity, and obscurity of information inputs. The more equivocal a

situation is, the more challenging it is to respond appropriately. Hence, organization

participants strive to manage equivocality in order to maintain a balance between

highly equivocal and highly unequivocal messages. This would allow us to

understand and respond effectively to different information inputs. Similarly, each

organizational participant processes messages in an attempt to transform equivocal

information inputs into understandable and predictable messages. As such, highly

equivocal message inputs must be processed by organization members (Kreps,

2008).

Weick’s model suggests two related communication processes used to cope with

the level of equivocality of information inputs, the use of rules and cycles. For

instance, rules help ascertain the level of familiarity in any message input, as well as

search the pool of standardized message responses available that are compatible

with the specific message input. Moreover, organizational members can usually

respond to simple message inputs with preset rules. For instance, health education

pamphlets, informed consent paperwork, letters, rate sheets, and printed

instructions are common rule-based strategies used in health care systems to

respond to common inputs (Kreps, 2008).

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 Kreps (2008) stated that communication behavior cycles are a series of

interlocked message exchanges between organizational actors that allow the

organization to process highly equivocal information by reducing the equivocality of

complex inputs. In this case, Weick’s model describes a cycle as a double interact, a

three-part exchange of conditionally related messages particularly the act, response,

and adjustment. In essence, the communication cycle introduces an idea, elicits a

response to that idea, and enables an adjustment to the response. Moreover, it is

also considered to be a way of gathering information and feedback. As such, the

more equivocal a given information input is for organizational members, the more

they must depend on performing a number of communication cycles to cope with

the problem.

Conclusion

In this article we have explored Weick’s model of organizing based on its

applications in health promotion and communication. Weick’s model emphasized

human interactions and information processing as the central activities of organizing.

As a communication theory, it represents the cybernetics perspective as it mainly

focuses on information processing and flow. As a communication model, it

represents a strong evidence towards being a hallmark of science that can be tested

and used for representing real world scenarios such as in health promotion.

Weick’s model represents the communication interactions and collective

information processing as the primary elements of social organization. Interpretation

and strategic reactions to environmental information inputs enable organizational

adaptation and survival. Information is the major input and output of organizing. The

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primary activity of organizations is to process information through communication

so organization members can react to inputs, creating the primary output of

organizations such as processed information. The information flow as embodied in

the cybernetics perspective provide the framework in which Weick’s model could be

compared with. With the use of complicated medical terminologies that are

considered to be equivocal, there is a need to simplify how health communicators

could make patients understand the message and provide an effective way of

delivering information to healthcare actors using Weick’s model of organizing.

References:

Coghill, G. (2018). Science or not: Hallmarks of Science. Retrieved from:

https://scienceornot.net/hallmarks-of-science/
Craig, R.T. (1999). Communication Theory as a Field. Retrieved from:
http://people.unica.it/ernestinagiudici/files/2014/03/CRAIG-COMMUNICATION-
THEO RY-AS-A-FIELD.pdf
Craig, R.T. (2007). Pragmatism in the Field of Communication Theory.
Communication Theory. 17 :125–145. doi:10.1111/j.1468-2885.2007.00292.x
Kreps, G.L. (2008). Applying Weick's model of organizing to health care and health
promotion: Highlighting the central role of health communication. Patient
Education and Counseling. 74 (3),pp 347-355.
https://doi.org/10.1016/j.pec.2008.12.002
Pavitt, C. (2010). Alternative Approaches to Theorizing in Communication Science.
Retrieved from: http://sk.sagepub.com/reference/hdbk_commsci/n3.xml

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