A discourse analysis of interaction between receptionists and patients in health facilities in Kisumu county, Kenya.

Abstract

Management of healthcare sector is very critical to the healing process. Receptionists are the first point of contact when patients visit health facilities. These receptionists who work in public facilities are employed by the ministry of health and managed by County governments while their counterparts who work in private health facilities fall under the hospital management, the human resource department. Private facilities in Kenya are represented by the Kenya healthcare federation. The duties of receptionists’ include registration of patients, organising appointments and keeping records of patients who visit healthcare facilities. Therefore, in the course of these duties, receptionists may facilitate or impede provision of health care services to patients through their language use. This study examines the interactions through which these activity types are accomplished at one public health facility and one private facility in Kenya. They are analysed and the discursive construction of roles and identities by receptionists and patients in the two separate, but related institutional contexts explored. Studies on institutional discourse have focused on transactional goals and neglected interpersonal dynamics that emerge in the course of interaction. This may lead to negative perceptions between receptionists and patients. This study is guided by the following objectives: firstly, to identify linguistic patterns and practices of discourse encounters at the two health facilities; secondly, to analyse these linguistic patterns and practices of discourse encounters at the two health facilities, thirdly, to examine how receptionists and patients enact their respective discourse roles and identities; lastly, to investigate the extent to which these linguistic patterns and practices are implicated in the construction and orientation to institutional power. Goffman’s (2002) theory of roles and identities is adopted in the study. The target population of the study consisted of receptionists in public health facilities and private health facilities and patients who visited these facilities for a period of one month. Instruments of data collection included tape recorders, interview schedules and questionnaires. Purposive sampling and iteration and saturation are used in the study. Data from naturally-occurring conversations among the receptionists and the patients is analysed using the qualitative research design. The discourse at the two facilities is found to consist of four stages. The four stages are constructed through predictable moves which are realised through limited speech moves and conversational styles. Different speech acts encode different levels of relational dynamics which is determined by social environment of each facility. Receptionists are also found to take varying attitudes towards their work. Some assume full responsibility for their actions while others attribute decisions to facilities. In the light of all these, it seems that the findings of this study about receptionists – client interaction might be of some value specifically in linguistics, policy makers, literature review and methodology. It is therefore proposed that the findings from this study be used in receptionist training programmes to raise awareness of communicative patterns of discourse roles at the reception with a view of improving both the professional experience of receptionists and the quality of service which patients at government health facilities and private health facilities receive. Quality customer service is equivalent to Vision 2030’s social pillar, which rests on the premise that investment in human capital is paramount for economic development.