Pastoral practices' for quality improvement in a Kenyan clinical network
Bibliographic Data
| ID | 4589685 |
|---|---|
| Authors | Gerry Mcgivern (0000-0002-0440-0787, University of Warwick, corresponding author), Jacinta Nzinga (0000-0001-8394-8857, Kenya Medical Research Institute), Mike English (0000-0002-7427-0826, University of Oxford) |
| Year | 2017 |
| Volume | 195 |
| Pages | 115-122 |
| Publication date | 2017-12-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2017.11.031 |
| PMID | 29175225 |
| OpenAlex | W2770279006 |
| Language | EN |
| Citations received | 10 |
| References cited | 33 |
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
Accountability · Audit · Business · Corporate governance · Governmentality · Health care · Participant observation · Political science · Public relations · Social science · Sociology · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Law · Medicine · Nursing · Primary Care and Health Outcomes · Accounting
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Professional identity transitions, violations and reconciliations among new nurses in low- and middle-income countries
Factors shaping network emergence
Understanding networks in low-and middle-income countries’ health systems
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Breaching the professional social contract to drive system innovation
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The Dynamics of Collective Leadership and Strategic Change in Pluralistic Organizations.
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Diffusion of Innovations in Service Organizations
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Clinical governance and governmentality
Foucault, Governmentality, and Critique
Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya
Profiling Patients’ Healthcare Needs to Support Integrated, Person-Centered Models for Long-Term Disease Management (Profile)
Power and Integrated Health Care
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Why is UK medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors
Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling
Between surveillance and subjectification
A new mode of organizing in health care? Governmentality and managed networks in cancer services in England
Motivation, money and respect
Theory Construction in Qualitative Research
Of Shepherds, Sheep and Sheepdogs? Governing the Adherent Self through Complementary and Competing 'Pastorates
Adaptive regulation or governmentality
Managerial relations in Kenyan health care
Spatializing States
| Unique citing works | 10 |
|---|---|
| Citations per year | 1,25 |
| Citation span | 2018 - 2025 (8) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 10 |