The clinical governance of the soul: ‘deep management’ and the self-regulating subject in integrated community mental health teams

The habitus of hygiene: Discourses of cleanliness and infection control in nursing work

“…Indeed, in conditions of uncertainty, as Brown and Crawford (2003) argue, health professionals can be thrown back upon their sense of professional identity; in this case the image of what it means to be a nurse and be the harbinger of hygiene. Cleanliness, orderliness and control are aligned such that one can make sure of things, check that protocols are being implemented and sterile procedures followed, check that you and your colleagues have washed their hands and tidied up after themselves and thereby enjoy a sense of security.…”

“…This corresponds to what has been called elsewhere "deep management" (Brown/Crawford 2003) such that a person"s involvement in the organisation"s work comes to be self monitoring and self controlled, so as to rely "for its effectiveness upon the self regulating capacities of its employees as subjects" (Du Gay 1997). Moreover there is a sense of having progressed as a result of undertaking these exercises, so that the personal story of individual or team career progression becomes aligned with the notion of progress in the competitive audit.…”

The Assertive Community Treatment Team as a Complex Dynamic System of Care

“…Hence, the success of the team resides in the patterns of connections between team members and how carefully they interrelate with one another, rather than the direction of an overt leader. Processes consistent with sensemaking and self-organization have been documented in integrated community mental health teams (Brown & Crawford, 2003). Similar to ACT teams, integrated community mental health teams have been shown to reduce hospitalizations, suicidal deaths, and costs (Simmonds, Coid, Joseph, Marriott, & Tyrer, 2001).…”

“…The team had weekly meetings that were kept deliberately non-hierarchical by rotating team leadership from week to week. To understand this regulation and orderliness in the field, the authors coined the term ''deep management,''which refers to ''management that goes on at a level which is subtler and more pervasive than the ordinary notions of direction and supervision associated with the term would imply'' (Brown & Crawford, 2003). Deep management is a product of a shared understanding by team members that relates to client care originating from their diverse professional identities and the value attached to this care.…”

Governing for Excellence in the Social Care Sector - The Role of Self-Governance in Ireland's Evolving Social Care Profession

“…Consequently, the significant aspect of (clinical) governance is the reliance on making individual practitioners responsible for developing their skills for accessing evidence, ensuring that practice is, as far as possible, 'evidence-based', and being responsible for their own professional development and accountable for their implementation of quality standards (NHS Executive 1999, Brown andCrawford 2003).…”