Patientinddragelse: den rette disponering!

Åse Mikkelsen

Student thesis: Master executive thesis


Patient involvement in the Danish health care system is a new phenomenon, which became a reality in the summer of 2013. Knowledge and experience on a national level is therefore a scarce. Due to the lack of experience when it comes to patient involvement in the Danish health care system, Danish hospitals have used a trial and error approach, which is loosely based on international experience. In this paper I will examine the strategy of involving patients and their relatives in Holbaek Hospital. It is the strategy as a management tool, which is the object of the project. The analysis conducted in this paper is solely based on a text level. I’m examining, how the institutional environments have been a determining factor in the 11 activities selected by the hospital. These 11 activities are part of the strategy concerning patient involvement, which constitutes what patient involvement is on this particular hospital. For this analysis I use the theories of institutional isomorphism created by Paul J DiMaggio & Walter W Powell and John W Meyer & Brian Rowan. Furthermore, I examine how the hospitals strategy for patient involvement in the health care system establishes certain visibility fields and how the staffs’ opportunities, when it comes to involving the patient and their relatives, are conditioned by the strategy. For this particular analysis I use Mitchell Dean’s interpretation of Foucault’s ideas about discourses, power and management along with Dean’s governmentality-analysis.The paper is a single case study and the empirical material is the hospitals strategy including both the appendix’ of the Strategy and the material, which according to the Strategy constitutes its boundaries. I found that the hospital had adjusted the Strategy’s activities to the norms and values that were the most dominating in the organizational field. This was done in order for the hospital to appear modern and responsible. The pressure from the hospitals organizational surroundings has resulted in nine of 11 activities in the hospitals strategy are selected on the basis of coercive isomorphism. Moreover, several of the 11 activities fit well with the efficiency logic at the hospital in general. Furthermore, I conclude that the main problem here the strategy seeks to control relates to bad results in the annual national patient experience surveys. A solution to this problem is to treat the patient as a responsible citizen. By doing so it’s possible to give the patient some kind of influence and freedom to choose what’s the right thing for the patient to do. Via empowering doctors and nurses, hopefully they could be motivated to include the patient despite the usual barriers such as lack of time and poor physical surroundings.

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2016
Number of pages68