Dialogue is a useful organizational strategy that supports a shared understanding that is useful in the solving complex problems. A community hospital challenged with publicly transparent quality metrics and the associated financial and reputation penalties developed a culture supportive of dialogue and participation and was the setting for this research. The purpose of the research was to explore the decisions and messages an executive leadership team implemented that support the practice of dialogue and facilitated a culture of participation. This retrospective, qualitative study reviewed documents and artifacts over a seven-year time span from 2007-2014. two sources, 1) the Operation Committee meetings and 2) The all- employee forums provided by the senior leadership were reviewed. These source were coded utilizing a predetermined coding scheme based upon information from 3 theories, 1) Isaac’s dimensions of dialogue, 2) Isaac’s action theory of dialogue and 3) Fischer’s levels of participation. These three theories when integrated provide a three dimensional perspective that supports the practice of dialogue. The conclusions of this study are that 1) A single theory of dialogue is not sufficient. 2. An effective model for communication must include, at a minimum, contain an aspect of action theory, a dimension of dialogue, and a level of participation. 3. Delaying decision-making in order to obtain feedback allows for the prolongation of deliberation and for the emergence of dialogue and deliberation and 4. Expansion of the deliberation time is a mechanism that helps the group to suspend assumptions and is a methodology supportive of dialogue. This research recommends a three step, “how to” approach to supporting dialogue and a culture of participation. The recommended pattern is to 1) ask for feedback thus 2) delaying the decision, and 3) listening to the feedback.

Library of Congress Subject Headings

Dissertations (EdD) -- Organizational change; Interpersonal communication; Hospitals -- Employees -- Case studies; Participation -- Case studies

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Davis, Kay D.;