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dc.contributor.authorHøyem, Audhild
dc.contributor.authorGammon, Barbara Deede
dc.contributor.authorBerntsen, Gro Karine Rosvold
dc.contributor.authorSteinsbekk, Aslak
dc.date.accessioned2018-08-13T12:16:16Z
dc.date.available2018-08-13T12:16:16Z
dc.date.issued2018-07-10
dc.description.abstract<p><i>Introduction</i>: In response to increase of patients with complex conditions, policies prescribe measures for improving continuity of care. This study investigates policies introducing coordinator roles in Norwegian hospitals that have proven challenging to implement.</p> <p><i>Methods</i>: This qualitative study of policy documents employed a discourse analysis inspired by Carol Bacchi’s ‘What‘s the problem represented to be?’. We analysed six legal documents (2011–2016) and selected parts of four whitepapers presenting the statutory patient care coordinator and contact physician roles in hospitals.</p> <p><i>Results</i>: The ‘problem’ represented in the policies is lack of coherent pathways and lack of stable responsible professionals. Extended personal responsibility for clinical personnel as coordinators is the prescribed solution. Their duties are described in terms of ideals for coherent pathways across conditions and contexts. System measures to support and orchestrate the individual patient’s pathway (e.g. resources, infrastructure) are scarcely addressed.</p> <p><i>Conclusions and Discussion</i>: We suggest that the policies’ construction of the ‘problem’ as a responsibility issue, result in that neither diversity of patients’ coordination needs, nor heterogeneity of hospital contexts regarding necessary system support for coordinators, is set on the agenda. Adoption of rhetoric from diagnosis-specific standardized pathways obscures unique challenges in creating coherent pathways for patients with complex needs.en_US
dc.descriptionSource at <a href=https://doi.org/10.5334/ijic.3617> https://doi.org/10.5334/ijic.3617</a>. Accepted manuscript version, licensed <a href=http://creativecommons.org/licenses/by-nc-nd/4.0/> CC BY-NC-ND 4.0.</a>en_US
dc.identifier.citationHøyem, A., Gammon, D., Berntsen, G.R. & Steinsbekk, A. (2018). Policies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitals. International Journal of Integrated Care, 18(3), 1-13. https://doi.org/10.5334/ijic.3617en_US
dc.identifier.cristinIDFRIDAID 1596754
dc.identifier.doihttps://doi.org/10.5334/ijic.3617
dc.identifier.issn1568-4156
dc.identifier.urihttps://hdl.handle.net/10037/13384
dc.language.isoengen_US
dc.publisherUbiquity Pressen_US
dc.relation.ispartofHøyem, A. (2019). Continuity of care for patients with long-term complex needs - implications for clinical hospital practice. (Doctoral thesis). <a href=https://hdl.handle.net/10037/15401>https://hdl.handle.net/10037/15401</a>
dc.relation.journalInternational Journal of Integrated Care
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.subjectcare pathwayen_US
dc.subjectcoordinated careen_US
dc.subjectcontinuity of careen_US
dc.subjectcomplexityen_US
dc.subjectintegrated careen_US
dc.subjecthospitalsen_US
dc.titlePolicies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitalsen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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