Personalised medicine in advanced cystic fibrosis

McKone, Edward F.

doi:10.1016/s2213-2600(16)30156-4

Cited by 1 publication

(1 citation statement)

References 7 publications

(7 reference statements)

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“…There has been excitement about the potential of quality improvement (QI) for enhancing global health and calls for a ‘quality revolution’ in health care ( Kruk et al, 2016 ). Yet, despite the existence of QI methodologies and some understanding of QI barriers and facilitators ( Batalden and Davidoff, 2007 , Buckley and Pittluck, 2015 ), we know little about how to develop social and organizational processes to convince professionals to implement QI into practice ( Berwick, 2012 , Hanefeld et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

‘Pastoral practices’ for quality improvement in a Kenyan clinical network

McGivern

Nzinga

English

2017

Social Science & Medicine

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We explain social and organisational processes influencing health professionals in a Kenyan clinical network to implement a form of quality improvement (QI) into clinical practice, using the concept of ‘pastoral practices’. Our qualitative empirical case study, conducted in 2015–16, shows the way practices constructing and linking local evidence-based guidelines and data collection processes provided a foundation for QI. Participation in these constructive practices gave network leaders pastoral status to then inscribe use of evidence and data into routine care, through championing, demonstrating, supporting and mentoring, with the support of a constellation of local champions. By arranging network meetings, in which the professional community discussed evidence, data, QI and professionalism, network leaders also facilitated the reconstruction of network members' collective professional identity. This consequently strengthened top-down and lateral accountability and inspection practices, disciplining evidence and audit-based QI in local hospitals. By explaining pastoral practices in this way and setting, we contribute to theory about governmentality in health care and extend Foucauldian analysis of QI, clinical networks and governance into low and middle income health care contexts.

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