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首页> 外文期刊>Sociology of health & illness >A 'movement for improvement'? A qualitative study of the adoption of social movement strategies in the implementation of a quality improvement campaign
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A 'movement for improvement'? A qualitative study of the adoption of social movement strategies in the implementation of a quality improvement campaign

机译：“改善运动”？对通过在实施质量改进运动方面采用社会运动策略的定性研究

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摘要

Given the difficulties of implementing top-down' quality improvements, health service leaders have turned to methods that empower clinicians to co-produce bottom-up' improvements. This has involved the adoption of strategies and activities associated with social movements, with clinicians encouraged to participate in collective action towards the shared goal of improvement. This paper examines the adoption of social movement methods by hospital managers as a strategy for implementing a quality improvement campaign'. Our case study suggests that, despite the claim of empowering clinicians to develop bottom-up' improvements, the use of social movement methods can be more narrowly concerned with engaging clinicians in pre-determined programmes of top-down' change. It finds a prominent role for hybrid' clinical leaders and other staff representatives in the mobilisation of the campaign, especially for enrolling clinicians in change activities. The work of these hybrids' suggests some degree of creative mediation between clinical and managerial interests, but more often alignment with the aspirations of management. The study raises questions about the translation of social movement's theories as a strategy for managing change and re-inventing professionalism.
机译：鉴于实施自上而下的质量改进的困难，卫生服务领导者已经转向授权临床医生共同产生自下而上的改进的方法。这涉及采用与社会运动相关的战略和活动，临床医生鼓励参加集体行动，以实现改进的共同目标。本文探讨了医院管理人员通过医院管理人员作为实施质量改善活动的战略。我们的案例研究表明，尽管临床医生的索赔，但临床能力发展自下而上的改进，但使用社会运动方法的使用可能更加狭隘地关注从事临床医生在预先确定的自上而下的变革方案中。它为杂交'临床领导人和其他工作人员代表在动员竞选活动中找到了突出的作用，特别是在改变活动中注册临床医生。这些杂交种的工作暗示了临床和管理兴趣之间的一定程度的创造性调解，但更常常与管理层的愿望保持一致。该研究提出了关于社会运动理论的翻译的问题，作为管理变革和重新发明专业性的战略。

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