Standardization for patient safety in a hospital department

Killing butterflies with a musket?

Jette Ernst, Astridur Jensen Schleiter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Purpose
The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a hospital department, the hospital management and standard inventers. We understand safety standardization and the responses to it as a strategizing process, where standards are legitimized, taken up, handled or countered.

Design/methodology/approach
Ethnographic fieldwork was conducted in a Danish hospital department. The study included observations, interviews and documents studies. The authors apply a Bourdieusian perspective, where the authors focus on the narratives told by standard inventers, managers and nurses to examine and understand their strategizing activities in relation to safety standardization. We understand strategizing as interested action emerging in the dialectics between a habitus and a position in a field.

Findings
The authors show how the standardization of work rests on the master narrative of patient safety management and how this narrative clashes with the nurses’ practical perception of good care, which rests on the counter-narrative of the clinical judgment.

Originality/value
Safety standardization in healthcare is often studied within the broader framework of performance management using functionalist outside-in and prescriptive approaches. This study contributes to this literature by approaching standardization and the responses to it as taking place in a dialectic movement between subjective shop floor experiences and wider field-level forces. Furthermore, the study contributes to the organization and management literature concerned with change and strategic action by endorsing the Bourdieusian conception of strategizing.
OriginalsprogEngelsk
TidsskriftQualitative Research in Organizations and Management
Vol/bind13
Udgave nummer4
Sider (fra-til)368-383
ISSN1746-5648
DOI
StatusUdgivet - 2018
Udgivet eksterntJa

Citer dette

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title = "Standardization for patient safety in a hospital department: Killing butterflies with a musket?",
abstract = "PurposeThe purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a hospital department, the hospital management and standard inventers. We understand safety standardization and the responses to it as a strategizing process, where standards are legitimized, taken up, handled or countered.Design/methodology/approachEthnographic fieldwork was conducted in a Danish hospital department. The study included observations, interviews and documents studies. The authors apply a Bourdieusian perspective, where the authors focus on the narratives told by standard inventers, managers and nurses to examine and understand their strategizing activities in relation to safety standardization. We understand strategizing as interested action emerging in the dialectics between a habitus and a position in a field.FindingsThe authors show how the standardization of work rests on the master narrative of patient safety management and how this narrative clashes with the nurses’ practical perception of good care, which rests on the counter-narrative of the clinical judgment.Originality/valueSafety standardization in healthcare is often studied within the broader framework of performance management using functionalist outside-in and prescriptive approaches. This study contributes to this literature by approaching standardization and the responses to it as taking place in a dialectic movement between subjective shop floor experiences and wider field-level forces. Furthermore, the study contributes to the organization and management literature concerned with change and strategic action by endorsing the Bourdieusian conception of strategizing.",
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Standardization for patient safety in a hospital department : Killing butterflies with a musket? / Ernst, Jette; Jensen Schleiter, Astridur.

I: Qualitative Research in Organizations and Management, Bind 13, Nr. 4, 2018, s. 368-383.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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