Health Care Analysis 20 (2):119-138 (2012)
Abstract |
Health care organizations are constantly seeking ways to improve quality of care and one of the often-posed solutions to deliver ‘good care’ is reflexivity. Several authors stress that enhancing the organizations’ and caregivers’ reflexivity allows for more situated, and therefore better care. Within quality improvement initiatives, devices that guarantee quality are also seen as key to the delivery of good care. These devices do not solely aim at standardizing work practices, but are also of importance in facilitating reflexivity. In this article, we study how quality improvement devices position the relationship between situated reflection and standardization of work processes. By exploring the work of Michel Callon, Michael Lynch, and Lucy Suchman on reflexivity in work practices, we study the development and introduction of the Care Living Plan. This device aimed to transform care organizations of older people from their orientation towards the system of care into organizations that take a client-centred approach. Our analysis of the construction of specific forms of reflexivity in quality devices indicates that the question of reflexivity does not need to be opposed to standardization and needs to be addressed not only at the level of where reflexivity is organizationally situated and who gets to do the reflecting, but also on the content of reflexivity, such as what are the issues that care workers can and cannot reflect upon. In this paper we point out the theoretical importance of a more detailed empirical study of the framing of reflexivity in care practices
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Keywords | Care for older people Good care Reflexivity Quality improvement Quality improvement devices |
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DOI | 10.1007/s10728-011-0179-7 |
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References found in this work BETA
Against Reflexivity as an Academic Virtue and Source of Privileged Knowledge.Michael Lynch - 2000 - Theory, Culture and Society 17 (3):26-54.
The Politics of Technology: On Bringing Social Theory Into Technological Design.Marc Berg - 1998 - Science, Technology and Human Values 23 (4):456-490.
Accounting and Washing: Good Care in Long-Term Psychiatry.Jeannette Pols - 2006 - Science, Technology, and Human Values 31 (4):409-430.
Citations of this work BETA
Professional Talk: How Middle Managers Frame Care Workers as Professionals.Lieke Oldenhof, Annemiek Stoopendaal & Kim Putters - 2016 - Health Care Analysis 24 (1):47-70.
Doctors as Resource Stewards? Translating High-Value, Cost-Conscious Care to the Consulting Room.Marjolein Moleman, Teun Zuiderent-Jerak, Marianne Lageweg, Gianni L. van den Braak & Tjerk Jan Schuitmaker-Warnaar - forthcoming - Health Care Analysis:1-25.
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