scholarly journals Talking it better: conversations and normative complexity in healthcare improvement

2021 ◽  
pp. medhum-2020-012129
Author(s):  
Alan Cribb ◽  
Vikki Entwistle ◽  
Polly Mitchell

In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ‘normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as ‘explanatory complexity’. In brief, normative complexity relates to the inherent difficulty of deciding what kinds of changes are ‘improvements’ or, more broadly, what is valuable in healthcare. We suggest that explanatory and normative complexity intersect and that anyone interested in healthcare improvement needs to be sensitive to both. After briefly introducing the idea of normative complexity, we consider some contrasting examples of conversations, reflecting on how they do and might contribute to healthcare quality. We discuss both conversations that are deliberately organised and facilitated (‘orchestrated conversations’) and more informally occurring and routine conversations. In the first half of the paper, we draw on some examples of orchestrated and routine conversations to open up these issues. In the second half of the paper, we bring some more theoretical lenses to bear on both conversations and normative complexity, summarise what we take to be the value of conversations and draw together some of the implications of our discussion. In summary, we argue that conversations can play a crucial role in negotiating the normative complexity of healthcare quality improvement because of their capacity to hold together a plurality of perspectives, to contribute and respond to emergence and to help underpin institutional conditions for empathy and imagination.

2019 ◽  
Vol 46 (2) ◽  
pp. 118-122
Author(s):  
Alan Cribb ◽  
Vikki Entwistle ◽  
Polly Mitchell

In this paper, we argue that there are important ethical questions about healthcare improvement which are underexplored. We start by drawing on two existing literatures: first, the prevailing, primarily governance-oriented, application of ethics to healthcare ‘quality improvement’ (QI), and second, the application of QI to healthcare ethics. We show that these are insufficient for ethical analysis of healthcare improvement. In pursuit of a broader agenda for an ethics of healthcare improvement, we note that QI and ethics can, in some respects, be treated as closely related concerns and not simply as externally related agendas. To support our argument, we explore the gap between ‘quality’ and ‘ethics’ discourses and ask about the possible differences between ‘good quality healthcare’ and ‘good healthcare’. We suggest that the word ‘quality’ both adds to and subtracts from the idea of ‘good healthcare’, and in particular that the technicist inflection of quality discourses needs to be set in the context of broader conceptualisations of healthcare improvement. We introduce the distinction between quality as a measurable property and quality as an evaluative judgement, suggesting that a core, but neglected, question for an ethics of healthcare improvement is striking the balance between these two conceptions of quality.


Author(s):  
Anastasia K. Kadda

The aim of this study is to describe the social role of technology in healthcare quality improvement. Methodologically, the study was based on a review of the relevant literature, Greek and foreign, as well as Internet sources related to the social role of technology in healthcare quality improvement. The main conclusions drawn were the following: a) The development of new technologies in the field of health and their involvement within the social context is today a fast accelerating process; b) The presentday expansion of health-oriented technology is of vital importance because of current trends in the field of healthcare and of the social evolution on healthcare services; c) Information technology is capable of profoundly contributing to the improvement of the quality of health, and thus to the wellbeing of the citizens in a society; d) By the use of health technology, more efficient and productive financial management is achieved with numerous benefits for the economy; e) Electronic health can improve the quality of healthcare thereby facilitating the work of health professionals; f) Greek society is being increasingly influenced by both international and domestic scientific and technological advances in health technology despite the existence of significant legal barriers; g) Current trends in the European Union as far as health technology is concerned are intimately connected with expanding citizen participation in the electronic revolution and their increasing access to the Information Society.


2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Jyoti Kotecha ◽  
Han Han ◽  
Michael Green ◽  
Grant Russell ◽  
Mary I Martin ◽  
...  

2016 ◽  
Vol 32 (suppl 2) ◽  
Author(s):  
Margareth Crisóstomo Portela ◽  
Sheyla Maria Lemos Lima ◽  
Mônica Martins ◽  
Claudia Travassos

Abstract: The development and study of healthcare quality improvement interventions have been reshaped, moving from more intuitive approaches, dominated by biomedical vision and premised on easy transferability, to gradually acknowledge the need for more planning and systematization, with greater incorporation of the social sciences and enhancement of the role of context. Improvement Science has been established, with a conceptual and methodological framework for such studies. Considering the incipient of the debate and scientific production on Improvement Science in Brazil, this article aims to expound its principal conceptual and theoretical fundamentals, focusing on three central themes: the linkage of different disciplines; recognition of the role of context; and the theoretical basis for the design, implementation, and evaluation of interventions.


2020 ◽  
Vol 9 (4) ◽  
pp. e001104
Author(s):  
Pamela Mathura ◽  
Miriam Li ◽  
Natalie McMurtry ◽  
Narmin Kassam

Sign in / Sign up

Export Citation Format

Share Document