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Between diagnostic precision and rapid decision‐making: Using institutional ethnography to explore diagnostic work in the context of Cancer Patient Pathways in Norway
Sociology of Health & Illness ( IF 2.957 ) Pub Date : 2021-02-26 , DOI: 10.1111/1467-9566.13235
Siri Christine K Naess 1 , Erna Håland 1
Affiliation  

Alongside other Nordic countries, the Norwegian government has introduced Cancer Patient Pathways (CPPs) for faster diagnostic assessment and timely treatment to improve the quality of cancer care. A key aspect of CPPs is the introduction of time limits for each phase of the diagnostic investigation. Occurring simultaneously are ongoing advances in medical technology, complicating the process of diagnosing and treating cancer. In this article, using institutional ethnography, we examine: how does the CPP policy influence physicians' experiences of diagnostic work? Data were collected from May 2018 to May 2019, through semi‐structured interviews with physicians across five hospitals in Norway (N = 27). Our findings indicate that the implementation of various strategies aimed at enhancing quality in cancer care collide, compelling physicians to negotiate between diagnostic precision and rapid decision‐making. We conclude that attention to interfaces between multiple guidelines and their implications for practice is crucial for understanding and developing quality of care.

中文翻译:

在诊断精度和快速决策之间:使用机构民族志在挪威癌症患者途径的背景下探索诊断工作

与其他北欧国家一起,挪威政府引入了癌症患者途径 (CPP),以加快诊断评估和及时治疗,以提高癌症护理质量。CPP 的一个关键方面是为诊断调查的每个阶段引入时间限制。同时发生的是医疗技术的不断进步,使诊断和治疗癌症的过程复杂化。在本文中,我们使用制度民族志研究:CPP 政策如何影响医生的诊断工作经验?数据收集自 2018 年 5 月至 2019 年 5 月,通过与挪威五家医院的医生进行半结构化访谈(N = 27)。我们的研究结果表明,旨在提高癌症护理质量的各种策略的实施发生冲突,迫使医生在诊断精度和快速决策之间进行协商。我们得出的结论是,关注多个指南之间的接口及其对实践的影响对于理解和发展护理质量至关重要。
更新日期:2021-04-24
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