Spenningsfeltet mellom standardisering, variasjon og prioritering i norske sykehjem
Engelsk titel: Tensions between standardization, variation and prioritization in Norwegian nursing homes
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Författare:
Isaksen, Jörn
;
Ågotnes, Gudmund
;
Fagertun, Anette
Email: jorn.isaksen@ntnu.no
Språk: Nor
Antal referenser: 43
Dokumenttyp:
Artikel
UI-nummer: 18080113
Sammanfattning
Service standards involve, amongst other things, an institutional aim of regulation, often through descriptions of «best practice». The aim of the introduction of service standards is to improve the overall quality of the services. The use of standards in the Norwegian healthcare sector, the empirical theme of this article, is, ultimately, a means to equate or level the expectations of the various services. The aim of this study is to explore how Norwegian nursing homes work with «quality» and if, or in what ways, this work has led to more unified practices within and across nursing homes.
This study draws on empirical material from 2016, collected through a quantitative survey, and qualitative interviews and observations from five nursing homes in Norwegian municipalities.
We found significant variation in practice and routines despite repeated efforts by the authorities to standardize practices in the services. The results show that most variables vary considerably across and within the included nursing homes. The described variation is discussed in relation to what is understood as a complex and perpetual tension between standardization, local/municipal autonomy, «workplace cultures» and the growing demand for innovative services. We argue that standardization of 'best practice' can be difficult to reconcile with (a) the desire for innovative and individually adjusted services, and (b) the fundamental municipal autonomy prevalent in Norway, and the local «workplace cultures» this autonomy is connected to.