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Article
Publication date: 29 May 2018

Anja Svejgaard Pors

The purpose of this paper is to examine the relational consequences of electronic patient records based on co-produced data from pregnant women’s IT supported…

Abstract

Purpose

The purpose of this paper is to examine the relational consequences of electronic patient records based on co-produced data from pregnant women’s IT supported self-reporting. The analysis unfolds how the clinical encounter between patient and professional is reconfigured in the digitized society.

Design/methodology/approach

The paper provides a grounded theory analysis based on observations and interviews in an antenatal care unit. The study draws on empirical material generated through observations of the clinical encounters between pregnant women and midwifes, interviews with managers and midwifes, field notes and policy documents.

Findings

The author argues that the use of technology and co-produced data displace tasks and relations between healthcare professional and patient. The analysis shows that four modes of organizational patient involvement are enacted: involvement in administrative tasks, involvement in professional resistance, individualized involvement, and homogenized involvement of patients that tends to categorize the pregnancy roughly as either “normal” or “abnormal.”

Originality/value

This study contributes to qualitative research in digitization and patient involvement in health organization studies by showing how digital technology distributes the midwife’s autonomy, tasks and knowledge about the patient with both intended and unintended consequences. The argument goes beyond the prevalent prescriptive approaches to e-government and co-production, instead providing a critical analytical perspective on the promises of delivering efficient and patient-centered healthcare.

Details

Journal of Health Organization and Management, vol. 32 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Abstract

Details

Journal of Organizational Ethnography, vol. 10 no. 1
Type: Research Article
ISSN: 2046-6749

Article
Publication date: 11 April 2016

Anja Svejgaard Pors

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and…

Abstract

Purpose

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations.

Design/methodology/approach

The paper provides an analysis of four documents collected as part of an ethnographic case study regarding “The Perspective of the Patient” – a Danish Hospital’s patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis.

Findings

The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns.

Originality/value

This study contributes to qualitative research in organizational health communication by combining two subfields – patient-centredness and health communication – in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization.

Details

Journal of Health Organization and Management, vol. 30 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 13 July 2015

Anja Svejgaard Pors

The purpose of this paper is to examine the impact of e-government reforms on street-level bureaucrats’ professionalism and relation to citizens, thus demonstrating how…

1496

Abstract

Purpose

The purpose of this paper is to examine the impact of e-government reforms on street-level bureaucrats’ professionalism and relation to citizens, thus demonstrating how the bureaucratic encounter unfolds in the digital era.

Design/methodology/approach

The paper is based on an ethnographic study of frontline work at a citizen service centre in a Danish municipality, and draws on empirical material generated through observations, field notes, interviews and policy documents.

Findings

The paper shows that e-government changes the mode of professionalism in citizen service from service to support. An ethnographic account of how digital reforms are implemented in practice shows how street-level bureaucrat’s classic tasks such as specialized casework are being reconfigured into educational tasks that promote the idea of “becoming digital”. In the paper, the author argues that the work of “becoming digital” in client processing entails two interconnected changes in frontline agents’ practice: de-specialization of the task and intensified informality in relation to citizens. As a result, the frontline agent works as an explorative generalist whose professional skills and personal competencies are blurred.

Originality/value

The study contributes to ethnographic research in public administration by combining two separate subfields, e-government and street-level bureaucracy, to discern recent transformations in public service delivery. In the digital era, tasks, control and equality are distributed in ways that call for symmetrical and relational approaches to studying street-level bureaucracy. The argument goes beyond technological or social determinism to find a fruitful intermediary position pointing at technological change as having both constraining and enabling effects.

Details

Journal of Organizational Ethnography, vol. 4 no. 2
Type: Research Article
ISSN: 2046-6749

Keywords

Content available
Article
Publication date: 13 July 2015

Karen Boll and Roderick A.W. Rhodes

3421

Abstract

Details

Journal of Organizational Ethnography, vol. 4 no. 2
Type: Research Article
ISSN: 2046-6749

Content available
Article
Publication date: 7 December 2021

Mike Rowe and Bagga Bjerge

128

Abstract

Details

Journal of Organizational Ethnography, vol. 10 no. 3
Type: Research Article
ISSN: 2046-6749

Article
Publication date: 15 October 2020

Amalie M. Hauge

The purpose of this paper is to offer an overview of contemporary approaches to the challenge of managing positionality and to discuss their applicability to fieldwork in…

Abstract

Purpose

The purpose of this paper is to offer an overview of contemporary approaches to the challenge of managing positionality and to discuss their applicability to fieldwork in contested fields.

Design/methodology/approach

The paper is driven by the author's experience of disconcertment during her fieldwork for a study of economic prioritization of access to new pharmaceuticals. Here she was pushed to take sides between health economists, clinicians and patients. Based on an iterative literature review, the paper identifies contemporary approaches to side-taking and discusses their practical applicability by constructing counterfactual accounts of a specific situation related to her fieldwork.

Findings

The author provides an overview of three “modes of intervention” characteristic of contemporary ethnography: political activism, organizational development and intervening description. The author presents the research agenda, the methodological principles and the means of intervention of each of the three modes, and discusses their applicability to the fieldwork process.

Practical implications

The overview of contemporary approaches to managing positionality is relevant for researchers doing fieldwork in contested fields. The paper discusses the strengths and weaknesses of the different approaches, and is intended as a resource for ethnographers who want to clarify their own positionality and prepare or improve their strategies on how to take sides in the process of doing fieldwork.

Originality/value

While the question of how to take sides is a classical challenge for organizational ethnographers, only few studies exist that look across contemporary ethnographic positions on how to manage positionality in the process of doing fieldwork. In addition to providing an overview for the individual ethnographer, this paper aims to participate in a collective academic conversation on the subject of managing positionality in the process of doing fieldwork.

Details

Journal of Organizational Ethnography, vol. 10 no. 1
Type: Research Article
ISSN: 2046-6749

Keywords

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