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Talking it better: conversations and normative complexity in healthcare improvement
In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ‘normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867266/ https://www.ncbi.nlm.nih.gov/pubmed/34035179 http://dx.doi.org/10.1136/medhum-2020-012129 |
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author | Cribb, Alan Entwistle, Vikki Mitchell, Polly |
author_facet | Cribb, Alan Entwistle, Vikki Mitchell, Polly |
author_sort | Cribb, Alan |
collection | PubMed |
description | In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ‘normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as ‘explanatory complexity’. In brief, normative complexity relates to the inherent difficulty of deciding what kinds of changes are ‘improvements’ or, more broadly, what is valuable in healthcare. We suggest that explanatory and normative complexity intersect and that anyone interested in healthcare improvement needs to be sensitive to both. After briefly introducing the idea of normative complexity, we consider some contrasting examples of conversations, reflecting on how they do and might contribute to healthcare quality. We discuss both conversations that are deliberately organised and facilitated (‘orchestrated conversations’) and more informally occurring and routine conversations. In the first half of the paper, we draw on some examples of orchestrated and routine conversations to open up these issues. In the second half of the paper, we bring some more theoretical lenses to bear on both conversations and normative complexity, summarise what we take to be the value of conversations and draw together some of the implications of our discussion. In summary, we argue that conversations can play a crucial role in negotiating the normative complexity of healthcare quality improvement because of their capacity to hold together a plurality of perspectives, to contribute and respond to emergence and to help underpin institutional conditions for empathy and imagination. |
format | Online Article Text |
id | pubmed-8867266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-88672662022-03-15 Talking it better: conversations and normative complexity in healthcare improvement Cribb, Alan Entwistle, Vikki Mitchell, Polly Med Humanit Original Research In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ‘normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as ‘explanatory complexity’. In brief, normative complexity relates to the inherent difficulty of deciding what kinds of changes are ‘improvements’ or, more broadly, what is valuable in healthcare. We suggest that explanatory and normative complexity intersect and that anyone interested in healthcare improvement needs to be sensitive to both. After briefly introducing the idea of normative complexity, we consider some contrasting examples of conversations, reflecting on how they do and might contribute to healthcare quality. We discuss both conversations that are deliberately organised and facilitated (‘orchestrated conversations’) and more informally occurring and routine conversations. In the first half of the paper, we draw on some examples of orchestrated and routine conversations to open up these issues. In the second half of the paper, we bring some more theoretical lenses to bear on both conversations and normative complexity, summarise what we take to be the value of conversations and draw together some of the implications of our discussion. In summary, we argue that conversations can play a crucial role in negotiating the normative complexity of healthcare quality improvement because of their capacity to hold together a plurality of perspectives, to contribute and respond to emergence and to help underpin institutional conditions for empathy and imagination. BMJ Publishing Group 2022-03 2021-05-25 /pmc/articles/PMC8867266/ /pubmed/34035179 http://dx.doi.org/10.1136/medhum-2020-012129 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Cribb, Alan Entwistle, Vikki Mitchell, Polly Talking it better: conversations and normative complexity in healthcare improvement |
title | Talking it better: conversations and normative complexity in healthcare improvement |
title_full | Talking it better: conversations and normative complexity in healthcare improvement |
title_fullStr | Talking it better: conversations and normative complexity in healthcare improvement |
title_full_unstemmed | Talking it better: conversations and normative complexity in healthcare improvement |
title_short | Talking it better: conversations and normative complexity in healthcare improvement |
title_sort | talking it better: conversations and normative complexity in healthcare improvement |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867266/ https://www.ncbi.nlm.nih.gov/pubmed/34035179 http://dx.doi.org/10.1136/medhum-2020-012129 |
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