Decline of the Hospital: Reconstructing Institutional Dangers

Armstrong, David

doi:10.1111/1467-9566.00110

Cited by 23 publications

(21 citation statements)

References 17 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the sociologists of risk speculated, institutions and expert cultures create second‐order risks whose relative importance is subsequently contested. As in other studies (Armstrong , Kohn et al . ) of clinical decision‐making, we found that VTE risks were seen not as a stand‐alone problem but as one of many risks occurring in complex hospital environments.…”

Section: Resultssupporting

confidence: 76%

See 1 more Smart Citation

Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care

Boiko

Sheaff

Child

et al. 2014

Sociology Health & Illness

View full text Add to dashboard Cite

Drawing on wider sociologies of risk, this article examines the complexity of clinical risks and their management, focusing on risk management systems, expert decision-making and safety standards in health care. At the time of this study preventing venous thromboembolism (VTE) among in-patients was one of the top priorities for hospital safety in the English National Health Service (NHS). An analysis of 50 interviews examining hospital professionals' perceptions about VTE risks and prophylaxis illuminates how National Institute for Health and Clinical Excellence (NICE) guidelines influenced clinical decision-making in four hospitals in one NHS region. We examine four themes: the identification of new risks, the institutionalisation and management of risk, the relationship between risk and danger and the tensions between risk management systems and expert decision-making. The implementation of NICE guidelines for VTE prevention extended managerial control over risk management but some irreducible clinical dangers remained that were beyond the scope of the new VTE risk management systems. Linking sociologies of risk with the realities of hospital risk management reveals the capacity of these theories to illuminate both the possibilities and the limits of managerialism in health care.

show abstract

Section: Resultssupporting

confidence: 76%

“…‘The risk of a VTE is, ironically, exacerbated by hospitalisation itself because hospitals themselves were ‘creating institutional dangers, such as bed rest that made patients viable to peripheral venous thrombosis' (Armstrong : 451). Prolonged bed rest makes patients susceptible to deep venous thrombosis (DVT) in the legs.…”

Section: Introductionmentioning

confidence: 99%

Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care

Boiko

Sheaff

Child

et al. 2014

Sociology Health & Illness

View full text Add to dashboard Cite

show abstract

“…To think health in the public mind is still to think hospitals. And yet, as Armstrong (1998) has noted, the asylums are now largely closed, and the hospital is now playing a less central role both in its place in the life of the patient and its place in the budget of health care. Developments have gathered pace since 1997 under New Labour.…”

Section: Health Care In and Beyond The Hospitalmentioning

confidence: 99%

Some of our concepts are missing: reflections on the absence of a sociology of organisations in Sociology of Health and Illness

Davies

2003

Sociology Health & Illness

View full text Add to dashboard Cite

The task of examining just how the concept of 'organisations' has fared in Sociology of Health and Illness in its first 25 years is in some ways unrewarding. The answer has to be -'not at all well'. But why is this and does it matter? Part one of this paper considers what research on health care organisations was being conducted in the early years of the Journal and why that work was not viewed with favour by sociologists. Part two examines the growing gulf between those who saw themselves principally as responding to the call for a sociology of health and illness informed by broader sociological theory, and those who regarded themselves more as analysts of health policy and practice. Postmodernism, curiously, has begun to open up something of a route back. Just what might be done to create a closer rapprochement between those calling for theory and those wanting to address some of the day to day challenges of the delivery and experience of health care in the 21 st century are topics for the final section.

show abstract

“…Research has demonstrated that hospitals were not always places of safety in terms of hospital acquired infection, complications of prolonged bed rest and psychological effects of hospital regimes (Armstrong, 1998;Gordan, 2006). Therefore the economic benefits of day surgery in terms of efficiency in getting as many patients through the system, as well as individual patient benefits such as reduced hospital stay and speedy recovery ensures that day surgery continues to grow across the world (McWhinnie, 2009).…”

Section: International Development Of Day Surgerymentioning

confidence: 99%

“Like a trip to McDonalds”: A grounded theory study of patient experiences of day surgery

Mottram

2011

International Journal of Nursing Studies

View full text Add to dashboard Cite

Abstract:Background: The amount and complexity of (ambulatory) day surgery is rapidly expanding internationally. Nurses have a responsibility to provide quality care for day surgery patients. To do this they must understand all aspects of the patient experience. There is dearth of research into day surgery using a sociological frame of reference. Objective: The study investigated patients' experiences of day surgery using a sociological frame of reference. Design: A qualitative study using the Grounded Theory approach was used. Setting: The study was based in two day surgery units in two urban public hospitals in the United Kingdom. Participants: 145 patients aged 18-70 years and 100 carers were purposely selected from the orthopaedic, ear nose and throat and general surgical lists. They were all English speaking and were of varied socio-economic background. Methods: The data was collected from [2004][2005][2006]. Semi-structured interviews were conducted on 3 occasions: before surgery, 48 hours following surgery and one month following discharge. Permission was received from the Local Research Ethics Committee. Analysis of the data involved line-by line analysis, compilation of key words and phrases (codes) and constant comparison of the codes until categories emerged. Findings: Patients liked day surgery and placed it within the wider societal context of efficiency and speed. Time was a major issue for them. They wished surgery, like all other aspects of their life to be a speedy process. They likened it to a McDonald's experience with its emphasis on speed, predictability and control. Conclusion: This study throws new light on patient experiences and offers an understanding of day surgery against a western culture which emphasises the importance of speed and efficiency. It is a popular choice for patients but at times it can be seen to be a mechanistic way of providing care. The implications for nurses to provide education and information to add to the quality of the patient experience are discussed.

show abstract

Decline of the Hospital: Reconstructing Institutional Dangers

Cited by 23 publications

References 17 publications

Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care

Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care

Some of our concepts are missing: reflections on the absence of a sociology of organisations in Sociology of Health and Illness

“Like a trip to McDonalds”: A grounded theory study of patient experiences of day surgery

Contact Info

Product

Resources

About