Between quality standards and clinical practice

Abstract

Management in health care has been an important area of research over several decades. Among other things, a key theme has been the meeting and interplay between public initiatives of control, transparency, documentation etc. and the many strategies of health professions to resist these initiatives and keep autonomy and control of work practices. This tension has resulted in the suggestion of new concepts such as hybrid managers or hybrid professions, as categories that integrate these initiatives with the health profession’s own ideas of clinical management. The analysis presented in this paper aims at contributing to the idea of hybridizations by focusing on the role of quality coordinators in the translation of national quality standards into localized practices. Quality coordinators are a function established in many Danish hospitals, responding to the many demands of practicing quality work in Danish Healthcare. The Danish Healthcare Quality Program is one of the newest and most comprehensive sources of those demands. In this program, both quality standards and methods of monitoring quality are described; providing the quality coordinator with a legitimate position to engage with the processes of improving clinical practice. In this way, quality coordinators facilitate the connections of quality standards with leaders and healthcare professionals. As a result, connections are established across both organizational and professional divisions, resulting in changed conditions for clinical work.