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From boundary concept to boundary object: the practice and politics of care pathway development

Allen, Davina Ann 2009. From boundary concept to boundary object: the practice and politics of care pathway development. Social Science and Medicine 69 (3) , pp. 354-361. 10.1016/j.socscimed.2009.05.002

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Abstract

Care pathways are multidisciplinary care management technologies which map out chronologically activities in a healthcare process. In the UK, they are advanced as a mechanism for enacting the changes called for under clinical governance. The terminological imprecision of care pathway methodology has enabled it to align clinical, management and service user interests and helps to explain the growing popularity of care pathways as quality improvement tools. Whilst it is possible to identify a ‘zone of agreement’ between these social worlds, there exists a fuzzy periphery characterised by conflicting agendas, which presents challenges for those charged with inscribing these interests into the pathway artefact. Drawing on a qualitative case study of a mental health safety care pathway in the UK, this paper examines the processes by which originators negotiated and settled upon a given design. The data reveal inherent tensions within pathway technology and the knowledge developers draw upon in devising strategies to overcome these challenges.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > RT Nursing
Uncontrolled Keywords: UK; Care pathways; Technologies-in-practice; Organisation; Managerialism; Professionalism; Mental healthcare; Clinical governance
Publisher: Elsevier
ISSN: 0277-9536
Last Modified: 09 Jan 2018 16:05
URI: http://orca.cf.ac.uk/id/eprint/12098

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