Framing Reflexivity in Quality Improvement Devices in the Care for Older People

Health Care Analysis 20 (2):119-138 (2012)
Health care organizations are constantly seeking ways to improve quality of care and one of the often-posed solutions to deliver ‘good care’ is reflexivity. Several authors stress that enhancing the organizations’ and caregivers’ reflexivity allows for more situated, and therefore better care. Within quality improvement initiatives, devices that guarantee quality are also seen as key to the delivery of good care. These devices do not solely aim at standardizing work practices, but are also of importance in facilitating reflexivity. In this article, we study how quality improvement devices position the relationship between situated reflection and standardization of work processes. By exploring the work of Michel Callon, Michael Lynch, and Lucy Suchman on reflexivity in work practices, we study the development and introduction of the Care Living Plan. This device aimed to transform care organizations of older people from their orientation towards the system of care into organizations that take a client-centred approach. Our analysis of the construction of specific forms of reflexivity in quality devices indicates that the question of reflexivity does not need to be opposed to standardization and needs to be addressed not only at the level of where reflexivity is organizationally situated and who gets to do the reflecting, but also on the content of reflexivity, such as what are the issues that care workers can and cannot reflect upon. In this paper we point out the theoretical importance of a more detailed empirical study of the framing of reflexivity in care practices
Keywords Care for older people  Good care  Reflexivity  Quality improvement  Quality improvement devices
Categories (categorize this paper)
DOI 10.1007/s10728-011-0179-7
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
Download options
PhilPapers Archive

Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 24,392
External links
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles
Maya J. Goldenberg (2012). Defining Quality of Care Persuasively. Theoretical Medicine and Bioethics 33 (4):243-261.
John B. Davis & Matthias Klaes (2003). Reflexivity: Curse or Cure? Journal of Economic Methodology 10 (3):329-352.
Joseph Raz (2004). The Role of Well‐Being. Philosophical Perspectives 18 (1):269–294.
John D. Stobo (1997). Who Should Manage Care? The Case for Providers. Kennedy Institute of Ethics Journal 7 (4):387-389.
Ori Simchen (2013). Token-Reflexivity. Journal of Philosophy 110 (4):173-193.

Monthly downloads

Added to index


Total downloads

13 ( #332,823 of 1,924,703 )

Recent downloads (6 months)

1 ( #417,761 of 1,924,703 )

How can I increase my downloads?

My notes
Sign in to use this feature

Start a new thread
There  are no threads in this forum
Nothing in this forum yet.