Cristin-resultat-ID: 1596754
Sist endret: 14. august 2018 14:12
NVI-rapporteringsår: 2018
Resultat
Vitenskapelig artikkel
2018

Policies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitals

Bidragsytere:
  • Audhild Høyem
  • Barbara Deede Gammon
  • Gro Karine Rosvold Berntsen og
  • Aslak Steinsbekk

Tidsskrift

International Journal of Integrated Care
ISSN 1568-4156
e-ISSN 1568-4156
NVI-nivå 1

Om resultatet

Vitenskapelig artikkel
Publiseringsår: 2018
Volum: 18
Hefte: 3
Open Access

Importkilder

Scopus-ID: 2-s2.0-85052712058

Beskrivelse Beskrivelse

Tittel

Policies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitals

Sammendrag

Introduction: In response to increase of patients with complex conditions, policies prescribe measures for improving continuity of care. This study investigates policies introducing coordinator roles in Norwegian hospitals that have proven challenging to implement. Methods: This qualitative study of policy documents employed a discourse analysis inspired by Carol Bacchi’s ‘What‘s the problem represented to be?’. We analysed six legal documents (2011–2016) and selected parts of four whitepapers presenting the statutory patient care coordinator and contact physician roles in hospitals. Results: The ‘problem’ represented in the policies is lack of coherent pathways and lack of stable responsible professionals. Extended personal responsibility for clinical personnel as coordinators is the prescribed solution. Their duties are described in terms of ideals for coherent pathways across conditions and contexts. System measures to support and orchestrate the individual patient’s pathway (e.g. resources, infrastructure) are scarcely addressed. Conclusions and Discussion: We suggest that the policies’ construction of the ‘problem’ as a responsibility issue, result in that neither diversity of patients’ coordination needs, nor heterogeneity of hospital contexts regarding necessary system support for coordinators, is set on the agenda. Adoption of rhetoric from diagnosis-specific standardized pathways obscures unique challenges in creating coherent pathways for patients with complex needs.

Bidragsytere

Aktiv cristin-person

Audhild Høyem

  • Tilknyttet:
    Forfatter
    ved Kvalitets- og utviklingssenteret ved Universitetssykehuset Nord-Norge HF

Barbara Deede Gammon

  • Tilknyttet:
    Forfatter
    ved Nasjonalt senter for e-helseforskning ved Universitetssykehuset Nord-Norge HF
  • Tilknyttet:
    Forfatter
    ved Senter for pasientmedvirkn. og samhandlingsforskn. ved Oslo universitetssykehus HF

Gro Berntsen

Bidragsyterens navn vises på dette resultatet som Gro Karine Rosvold Berntsen
  • Tilknyttet:
    Forfatter
    ved Nasjonalt senter for e-helseforskning ved Universitetssykehuset Nord-Norge HF
  • Tilknyttet:
    Forfatter
    ved Allmennmedisin ved UiT Norges arktiske universitet
Aktiv cristin-person

Aslak Steinsbekk

  • Tilknyttet:
    Forfatter
    ved Institutt for samfunnsmedisin og sykepleie ved Norges teknisk-naturvitenskapelige universitet
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