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Drawing on a performative ontology, this article extends the literature on health promotion in organizations by exploring how health promotion is performed in care work. The focus of the study is on health promotion in a context of illness and/or decline, which form the core of the studied organizational activities. The paper addresses the following question: how do care workers working in elderly care and mental health care organizations accomplish health promotion in the context of illness and/or decline?

The article develops a performative approach and analyses material-discursive practices in health promoting care work. The empirical material includes 36 semi-structured interviews with care workers, observations and organizational documents.

Two central material-discursive health promoting practices in care work are identified: confirming that celebrates service users as residents and the organizations as a home, and balancing at the limits of health promotion. The practices of balancing make the limitations of health promotion discernible and involve reconciling health promotion with that which does not neatly fit into it (illness, unachievable care aims, the institution and certain organizing). In sum, the study shows how health promotion can structure processes in care homes where illness and decline often are particularly palpable.

The paper explores health promotion in a context rarely explored in organization studies. Previous organization studies have to some extent explored health promotion and care work, but typically separately. Further, the few studies that have adopted a performative approach to material-discursive practices in the context of care work have typically primarily focused on IT. We extend previous organization studies literature by producing new insights: (1) from an important organizational context of health promotion and (2) of under-researched entanglements of human and non-human actors in care work providing a performative theory of reconciling organizational tensions.

Technologies of measurement and self-monitoring of health data have become part of a metric everyday life in Denmark. As part of a change in Nordic Welfare society, Danish citizens are increasingly experiencing a digitisation of welfare services. This chapter explores the rationales behind the eGovernment strategy of Digital Welfare 2016–2020 in regard to health and discusses how this strategy encourages self-measurement and self-improvement through discourses of improvement at both state and citizen levels. By illustrating how performativity is embedded in current conceptions of health, this chapter emphasises how strategies of digitisation lean on a bio-citizenship where individuals with poor health capacities become dependent, not on a supporting welfare system, but paradoxically on their own self-management skills in order to receive health services. Based on the sociology of knowledge approach to discourse (SKAD) analysis, this chapter scrutinises central documents on the strategy of digital welfare. Our exploration provides a critical insight into the current digitisation of health care by illustrating how new virtues of citizenship are demanded in the digital era in relation to digital health, and furthermore represents a current challenge for Danish welfare in the schism between technology as empowering and a technocratic form of governance.

Health education still tends to be dominated by an approach designed to achieve individual behaviour change through the provision of knowledge to avoid risk. In contrast, a critical inquiry approach educates children and young people to develop their capacity to engage critically with knowledge, through reasoning, problem solving and challenging taken for granted assumptions, including the socially critical approach which investigates the impact of social and economic inequalities on, for example, health status and cultural understandings. The purpose of this paper is to explore the conditions of possibility for a socially critical approach to health education in schools. It examines the ways in which preservice health and physical education (HPE) teachers talked about their experiences of health education during their school-based practicum.

In total, 13 preservice HPE teachers who were about to graduate with a Bachelor of Health and Physical Education from a university in New South Wales, Australia were interviewed for the study. Five group interviews and one individual interview were conducted. The interviews were coded for themes and interpreted drawing on a biopedagogical theoretical framework as a way of understanding the salience of particular forms of knowledge in health education, how these are promoted and with what effects for how living healthily is understood.

The HPETE students talked with some certainty about the purpose of health education as a means to improve the health of young people – a certainty afforded by a medico-scientific view of health imbued with individualised, risk discourses. This purpose was seen as being achieved through using pedagogies, particularly those involving technology, that produced learning activities that were “engaging” and “relevant” for young people. Largely absent from their talk was evidence that they valued or practiced a socially critical approach to health education.

This paper has practical implications for designing health education teacher programmes that are responsive to expectations that contemporary school health education curricula employ a critical inquiry approach.

This paper addresses an empirical gap in the literature on the conditions of possibility for a socially critical approach to health education. It is proposed that rather than challenging HPE preservice teachers’ desires to improve the lives of young people, teacher educators need to work more explicitly within an educative approach that considers social contexts, health inequalities and the limitations of a behaviour change model.

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

This article addresses issues of calculation and economization in contemporary public organizations. In particular, it investigates how choices of organizing emergency health-care have been affected by accounting as a performative device. Special attention has been paid to how accounting brings about performative consequences in shaping the medical profession and its context.

The article employs qualitative research methods and draws its analysis on empirical data from in-depth interviews at an emergency health-care unit in Sweden.

It is demonstrated how accounting, in the form of calculations of treatment time and number of patients, enables performative consequences for medical professional work. It is also demonstrated how the use of accounting engages (re)descriptions of practices and roles, creates accounts of patients, and helps to sustain such (re)descriptions. Accounting terms (such as efficiency and control) have been reframed into medical terminology (such as health-care quality and security), ensuring and retaining (re)described medical professional work in terms of practices and emerging roles.

This article contributes to (1) the literature on accounting practices within health-care contexts by demonstrating a case where the accounting ideas and practices of medical professionals are coexistent and interwoven and (2) the increasing body of literature focusing on accountingization by showing how emerging calculative technologies carry performative power over medical professional work through formative (re)descriptions.

The performative approach views organizational routines as generative systems with internal aspects – ostensive and performative – and dynamics (Feldman and Pentland, 2003). The purpose of this paper is to better understand under which conditions the routine dynamics happens or not.

To deal with this issue, for 13 months, the authors conducted a comparative and longitudinal case studies based on the evolution of the organizational routines in absence management in two departments of a French hospital.

The results show contrasting dynamics in the studied organizational routines: one evolved, the other in contrast, seemed blocked. The authors suggest that the routine dynamics depends on the relative weight of its ostensive and performative aspects: a balance situation makes mutual adaptions possible and an imbalance situation leads to the conservation of defective routine. The research underlines also that, in the hospital context, the capacity of management and teams to discuss and to negotiate the implementation of external rules plays an important role in the balance of the internal dimensions of routine.

While the literature on performative approach focusses on the “how and why” the routine act as a source of continuous change, this research investigates more in depth the working of the routines dynamics itself. The issue of balance or imbalance introduces a new element in the framework of routine dynamics and can constitute an interesting focus for managers looking to transform their organizational routines.

The formation and spreading of market‐, management‐ and individual‐rights discourses into society, as well as the movement of consumerism, have paved the way for a transformation of the linguistic usage. The transformation suggests that the view of the care seeker has shifted from a waiting patient, via a consumer to a customer creating value. Another example of the process is that the former medical meeting between patient/doctor now is described as a service meeting. With this background, the purpose of this paper is to explore the transformation of linguistic usage and to analyse the performativity of the service management discourse in health care.

The concept of performativity (Butler) supported with discursive formation and subjectivization (Foucualt) is used as theoretical framework. The performativity of the discourse is understood as a vehicle within the discourse, which influences people on an ontological level that names and makes them active subjects in line with what the discourse is saying.

When the service management discourse travels into the world of health care, discursive tensions between medical‐, care‐ and management discourses follow. These become apparent in the distinction between the different discursive constructions of patient – related to passivity, and customer – related to the performative image of active participation in value creating health. Even if the customer in service management discourse is imagined as an agent for himself with power and individual responsibility it is doubtful if people view themselves as customers. The dialectics between the use of the customer concept in commercial service meetings and the patient – doctor meeting, which is illustrated, point to unexpressed and implicit presumptions of an ontological kind in the ways service management researchers describe service meetings. Recent health care research can be interpreted as if a majority of patients have a desire to be part of their value creating processes. Since the responsibilities and tasks of the professions in health care however are regulated by law and institutionalised, the process of delegating tasks to patients seems not to be a matter of course.

It seems to be problematic to replace the patient concept with the customer concept in general. This concept gives hardly much room for the vulnerability that characterises a sick person. A reasonable approach would of course be to use the customer concept in a nuanced way.

The paper demonstrates that the performativity of service management theories, through the use of discursive analysis, is valuable in order to understand shifts in linguistic usage.

Undocumented migrants experience major legal constraints in their health-care access. Little is known on how undocumented migrants cope with these limitations in health-care access as individuals. The purpose of this study is to explore the coping responses of undocumented migrants when they experience limited health-care access in face-to-face encounters with health-care providers.

The authors conducted multi-site ethnographic observations and 25 semi-structured in-depth interviews with undocumented migrants in Belgium. They combined the “candidacy model” of health-care access with models from coping literature on racism as a framework. The candidacy model allowed them to understand access to health care as a dynamic and interactive negotiation process between health-care workers and undocumented migrants.

Responses to impaired health-care access can be divided into four main strategies: (1) individuals can react with a self-protective response withdrawing from seeking further care; (2) they can get around the obstacle; (3) they can influence the health-care worker involved by deploying discursive or performative skills; or (4) they can seek to confront the source of the obstacle.

These findings point to the importance of care relations and social networks, as well as discursive and performative skills of undocumented migrants when negotiating barriers in access to health care.

This study refines the candidacy model by highlighting how individuals respond on a micro-level to shifts towards exclusionary health policies and, by doing so dynamically, change provision of health-care services.

This paper tracks how a policy recommended by management consultants becomes embedded as an integral part of leadership practice. It explores the launch of the concept of “talent management” by McKinsey & Company and how it becomes adopted as part of expected leadership practices in the English National Health Service. The use of Management Consultants globally has increased exponentially, and the paper considers this phenomenon and the ways in which management consultant advice influences public sector leadership and practice at local level.

A case study approach is adopted, focussing on the introduction of the concept of talent management into the English NHS, following the wider emergence of the concept through influential reports published by McKinsey & Company in the late 1990s. An analysis of the emergence of the concept is conducted drawing on this series of reports and the adoption of talent management policies and practices by the English government's Department of Health.

These influential reports by the management consultancy firm, McKinsey & Company, constituted an urgent need for this newly identified concept of talent management and the secrecy surrounding its reception. It is this mystery surrounding the decisions about a talent management strategy in the NHS and the concealment of decisions behind closed doors, which leads us to offer a theory of management consultants' influence on leaders as one of performative seduction.

Management consultancy is a vast business whose influence reaches deeply into public and private sector organisations around the world. Understanding of the variegated policies and practices that constitute contemporary modes of governance therefore requires comprehension of management consultants' role within those policies and practices. This paper argues that management consultants influence public sector leadership through insertion of their products into definitions of, and performative constitution of, local level leadership.

Seeks to explore the assumptions and limitations of current programmes for the creation of electronic patient records by comparing ICT programme statements with hospital uses of information.

Compares qualitative data from medical ICT programmes statements with data from ethnographic studies of hospital decision making. Uses actor‐network theory to develop a performative definition of information as that which secures a decision or “qualculation”, whether in the form of calculation or judgement.

Shows that decision making depends on a mix of formal and informal considerations that are, however, always restricted in scope and number. Shows that some of these are locally and organisationally contingent.

The ethnographic findings illustrate the character of information rather than offering data about the character of decisions in different clinical locations.

Caution is needed in the face of claims about ICT programmes in health care. It is possible to anticipate neither all the uses of information nor what will count as information in advance.

The paper develops a performative definition of information. This is whatever secures a decision in practice. Information thus reflects a situated process of simplification and bounding of relevancies. This suggests that information not only flows (which is assumed in ICT programme statements) but also is fluid, unpredictably changing its form and character. This claim is relevant both to the design and use of ICT in health care and to the theory of information.