The uses and implications of standards in general practice consultations.

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

The uses and implications of standards in general practice consultations. / Lippert, Maria Laura; Reventlow, Susanne; Kousgaard, Marius Brostrøm.

In: Health, Vol. 21, No. 1, 01.01.2017, p. 3-20.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Lippert, ML, Reventlow, S & Kousgaard, MB 2017, 'The uses and implications of standards in general practice consultations.', Health, vol. 21, no. 1, pp. 3-20. https://doi.org/10.1177/1363459315590245

APA

Lippert, M. L., Reventlow, S., & Kousgaard, M. B. (2017). The uses and implications of standards in general practice consultations. Health, 21(1), 3-20. https://doi.org/10.1177/1363459315590245

Vancouver

Lippert ML, Reventlow S, Kousgaard MB. The uses and implications of standards in general practice consultations. Health. 2017 Jan 1;21(1):3-20. https://doi.org/10.1177/1363459315590245

Author

Lippert, Maria Laura ; Reventlow, Susanne ; Kousgaard, Marius Brostrøm. / The uses and implications of standards in general practice consultations. In: Health. 2017 ; Vol. 21, No. 1. pp. 3-20.

Bibtex

@article{3b859b2815f847ebb6bc8bbd855b40ea,
title = "The uses and implications of standards in general practice consultations.",
abstract = "Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development has been introduced. Data from semi-structured interviews and observations among 17 general practitioners were analysed using an iterative analytical approach, which served to identify important variations in the uses and impacts of the technology. The most pronounced impact of the technology was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the ‘softer’ aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients.",
author = "Lippert, {Maria Laura} and Susanne Reventlow and Kousgaard, {Marius Brostr{\o}m}",
year = "2017",
month = "1",
day = "1",
doi = "10.1177/1363459315590245",
language = "English",
volume = "21",
pages = "3--20",
journal = "Health",
issn = "1363-4593",
publisher = "SAGE Publications",
number = "1",

}

RIS

TY - JOUR

T1 - The uses and implications of standards in general practice consultations.

AU - Lippert, Maria Laura

AU - Reventlow, Susanne

AU - Kousgaard, Marius Brostrøm

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development has been introduced. Data from semi-structured interviews and observations among 17 general practitioners were analysed using an iterative analytical approach, which served to identify important variations in the uses and impacts of the technology. The most pronounced impact of the technology was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the ‘softer’ aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients.

AB - Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development has been introduced. Data from semi-structured interviews and observations among 17 general practitioners were analysed using an iterative analytical approach, which served to identify important variations in the uses and impacts of the technology. The most pronounced impact of the technology was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the ‘softer’ aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients.

U2 - 10.1177/1363459315590245

DO - 10.1177/1363459315590245

M3 - Journal article

VL - 21

SP - 3

EP - 20

JO - Health

JF - Health

SN - 1363-4593

IS - 1

ER -

ID: 149037992