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Bringing about change in patient‐centred preventive care

Loni Ledderer (Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark)

International Journal of Public Sector Management

ISSN: 0951-3558

Article publication date: 1 June 2010




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.


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.


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.


The paper adds to the understanding of organizational dynamics at the micro‐level.



Ledderer, L. (2010), "Bringing about change in patient‐centred preventive care", International Journal of Public Sector Management, Vol. 23 No. 4, pp. 403-412.



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Copyright © 2010, Emerald Group Publishing Limited

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