Bringing about change in patient‐centred preventive care

Bringing about change in patient‐centred preventive care Purpose – This paper aims to explore how healthcare organizations in Denmark transform modern ideas of patient‐centred preventive care into organizational practice. Specific attention is given to the influence of existing organizational practices. Design/methodology/approach – A qualitative multiple case study design is used to explore “motivational interviewing”, a health behaviour concept that was introduced in preventive consultations in ten Danish clinics. From an institutional perspective, the concept may be understood as an “organizational recipe” that translates into organizational activities. Data are generated by observations, interviews and document reviews. Theory and data provide the framework for an analytical phase model. Findings – The paper reveals how abstract ideas on preventive care translate into specific activities in organizations following pre‐existing, general rules of medical practice. Disparities between clinics are related to distinctive local practices, such as clinics' conditions and preventive treatment practices that form local sets of editing rules. Differences in clinic performances result in variations in achieving the ideal of patient‐centred, preventive care prescribed by motivational interviewing. Research limitations/implications – It is acknowledged in medical practice that there are different conceptions of the ideal of preventive care. The paper points to the value of promoting transparency in clinical practice and of paying attention to the mismatch between external expectations and organizational capabilities. Originality/value – The paper adds to the understanding of organizational dynamics at the micro‐level. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Public Sector Management Emerald Publishing

Bringing about change in patient‐centred preventive care

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Publisher
Emerald Publishing
Copyright
Copyright © 2010 Emerald Group Publishing Limited. All rights reserved.
ISSN
0951-3558
DOI
10.1108/09513551011047297
Publisher site
See Article on Publisher Site

Abstract

Purpose – This paper aims to explore how healthcare organizations in Denmark transform modern ideas of patient‐centred preventive care into organizational practice. Specific attention is given to the influence of existing organizational practices. Design/methodology/approach – A qualitative multiple case study design is used to explore “motivational interviewing”, a health behaviour concept that was introduced in preventive consultations in ten Danish clinics. From an institutional perspective, the concept may be understood as an “organizational recipe” that translates into organizational activities. Data are generated by observations, interviews and document reviews. Theory and data provide the framework for an analytical phase model. Findings – The paper reveals how abstract ideas on preventive care translate into specific activities in organizations following pre‐existing, general rules of medical practice. Disparities between clinics are related to distinctive local practices, such as clinics' conditions and preventive treatment practices that form local sets of editing rules. Differences in clinic performances result in variations in achieving the ideal of patient‐centred, preventive care prescribed by motivational interviewing. Research limitations/implications – It is acknowledged in medical practice that there are different conceptions of the ideal of preventive care. The paper points to the value of promoting transparency in clinical practice and of paying attention to the mismatch between external expectations and organizational capabilities. Originality/value – The paper adds to the understanding of organizational dynamics at the micro‐level.

Journal

International Journal of Public Sector ManagementEmerald Publishing

Published: Jun 1, 2010

Keywords: Health services; Patient care; Medical practice; Patients; Organizational theory; Denmark

References

  • Clinician reflections on promotion of healthy behaviors in primary care practice
    Flocke, S.A.; Crabtree, B.F.; Stange, K.C.
  • The powers of association
    Latour, B.
  • Patient‐centredness: a conceptual framework and review of the empirical literature
    Mead, N.; Bower, P.

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