After outsourcing: Working collaboratively to deliver patient care?

Undermining the value of cleaning work and its contribution to patient care has led to the creation of an artificial divide between cleaning and care, which is used as a justification for outsourcing. Outsourcing fragments the system of care, where each part works separately towards the attainment of its own objectives. This qualitative research is an exploration of organizational arrangements after the outsourcing of cleaning services at Vancouver General Hospital that affect the gendered work of cleaning, and act as an impediment to the integration of workers and the smooth flow of work practice. Using feminist methodology within a systems thinking framework, this study argues that hospital cleaning and care work are highly integrated and for the delivery of patient care, a considerable amount of coordination between the different groups of workers is required. The artificial fragmentation of the system of care prevents from the attainment of efficiencies for the whole system and has ramifications for patient care.