Individualisert standardisering?

Abstract

FørsteamanuensisInstitutt for pedagogikk og livslang laering, NTNU erna.haland@ntnu.no Line MelbySeniorforsker SINTEF Teknologi og samfunn, avd. helse line.melby@sintef.no SAMMENDRAG Dagens helsevesen er preget av stadig økende krav om standardisering av pasientbehandling på den ene siden og stadig økende krav om individualisering av pasientbehandling på den andre siden. Med utgangspunkt i en analyse av politisk diskurs, undersøker vi i denne artikkelen hvordan god pasientbehandling -uttrykt som individualisering og standardisering -blir til i politiske taler som omhandler innføring av pakkeforløp for kreft. Vi finner at det argumenteres for en form for individualisert standardisering hvor pasienten skal få det beste fra to verdener. Talene henter dermed argumenter fra begge diskurser for å kommunisere en mer overordnet helsepolitisk strategi hvor organisering og ikke mer penger lanseres som løsning på helsepolitiske utfordringer, eksemplifisert gjennom innføringen av pakkeforløp for kreft. Nøkkelord:Helsetjeneste, individualisering, organisering, pakkeforløp for kreft, standardisering This article is downloaded from www.idunn.no.

Balancing standardisation and individualisation in transitional care pathways: a meta-ethnography of the perspectives of older patients, informal caregivers and healthcare professionals

“…Establishing and maintaining standards in healthcare is often considered a useful tool that contributes to the reduction of unnecessary variation in quality of care among patients. It also contributes to fair treatment, so that equal cases are treated equally, in addition to the fact that it can reduce large costs in health services [75]. At the same time, it is clear from our review that standardisation can come at the expense of PCC and that patients, relatives and HCPs felt that the individualisation of patient care intrinsic to PCC was difficult to achieve during transfer from specialists to primary healthcare services.…”

“…It seems that there was limited flexibility so that significant, individual variations between patients were overlooked, which led to poorer perceived quality of the care transition. Clearly, standards, as a result of established systems of patient care during transmission, often conflict with the intentions of PCC [75,76]. In many respects, the elements in PCC and the degree of emphasis on each element are poorly defined and agreed upon [74,75].…”

“…Clearly, standards, as a result of established systems of patient care during transmission, often conflict with the intentions of PCC [75,76]. In many respects, the elements in PCC and the degree of emphasis on each element are poorly defined and agreed upon [74,75]. It is also unclear to what extent and how PCC approaches apply to a dyadic patient-HCP encounter and within organisational or societal levels of healthcare decision making [76].…”

Elderly patients with complex health problems in the care trajectory: a qualitative case study

“…Standardised care pathways promote procedures and standardised activities. However, questions have been asked if these pathways are a risk to patient preferences and if individual needs will receive less attention [8,9].…”

Temporality and timework: Danish endometrial cancer patients’ experiences of an accelerated cancer patient pathway

“…Only one evaluation of the Danish CPPs has been conducted (Vinge et al, 2012), with a focus on organizational challenges and not patient perspectives. While the notion of time is considered biomedically important by being closely connected with survival, knowledge of how temporal structures within the CPP shape patients' clinical encounters and experiences is sparse (H˚aland and Melby, 2017;Probst et al, 2012). Waiting in relation to illness has been given significant attention in the literature.…”