Forms of Inattentiveness: The Production of Blindness in the Development of a Technology for the Observation of Quality in Health Services

Research dealing with governmental and managerial ideals and tools for transparency has observed how these tools co-create new types of blindness. It has documented the existence of three different types of blindness: blindness caused by power games, by cognitive limitations and blindness as a side effect of the categories applied. This paper puts forward a fourth type of organizational blindness in addition to the already documented ones, namely self-imposed blindness to potentially destructive information. This paper studies how relevant - but problematic - information is actively ignored and kept out of sight in the decision processes by looking at a specific case study involving the construction of a model intended to control, and render transparent, the quality of health services in Denmark. This paper outlines the forms of inattentiveness which make communication blind to information that could question the quality model. Five forms of inattentiveness are identified that function as answers to the question of how communication avoids actualizing relevant but also potentially destructive information. This study documents a considerable amount of blindness to potentially relevant themes and it points to activities that produce this blindness as they reduce the probability that potentially destructive subjects are actualized. Information is not only something organizations need, but may also be something they protect themselves against. In that case, the forms of inattentiveness may be a function that forms organizational processes.