Towards Innovation with Care
Edited by Lars Fuglsang
Chapter 4: Innovation with Care in Health Care: Translation as an Alternative Metaphor of Innovation and Change
John Damm Scheuer INTRODUCTION An innovation may be deﬁned as an idea, practice or object that is perceived as new by an individual or other unit of adoption (Rogers, 1983: 11). Innovation in the public sector1 may be divided into diﬀerent types of innovations: a new or improved service, a process innovation, an administrative innovation, system innovation, conceptual innovation and radical change of rationality (Koch and Hauknes, 2005). The focus of this chapter is the introduction of a process innovation in the form of a new idea and object aimed at organizing clinical pathways for patients in health care organizations. The idea/object is that of a “clinical pathway” which may be deﬁned as “a standardized, prewritten, one- or two-page document showing the interventions of all disciplines along a time schedule. In eﬀect, it is a grid, with time as one axis and staﬀ actions as the other” (Zander, 1995: 9). It was developed by the nurse Karen Zander and her team of nurses at the New England Medical Center Hospitals in Boston (Zander, 1995) (Garbin, 1995) (Hofmann, 1993). According to Karen Zander the idea of clinical pathways soon spread internationally because they were not conceptual, visually appealing, easy to write and eﬀective in reviewing and decreasing the length of stay of patients (Zander, 1995: 11). Following Vrangbæk (1999) the concept of New Public Management is related to a number of diﬀerent tools of governance which, based on economic and theoretical ideas about rationality...
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