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The Social Organization of Best Practice

An Institutional Ethnography of Physicians’ Work

Authors: Webster, Fiona

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  • One of the only institutional ethnographies from the standpoint of the physician
  • Uncovers the different elements of a complex institutional structure: the development, implementation, and everyday practice of evidence based medicine
  • Complicates our understanding of evidence based medicine and knowledge translation 
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eBook 58,84 €
price for Spain (gross)
  • ISBN 978-3-030-43165-5
  • Digitally watermarked, DRM-free
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  • Immediate eBook download after purchase
Hardcover 72,79 €
price for Spain (gross)
  • ISBN 978-3-030-43164-8
  • Free shipping for individuals worldwide
  • Immediate ebook access, if available*, with your print order
  • Usually dispatched within 3 to 5 business days.
  • The final prices may differ from the prices shown due to specifics of VAT rules
About this book

This book explores how best practice for acute stroke care was developed, translated and taken up in medical practice across various sites in the province of Ontario using institutional ethnographic research. Institutional ethnography, an approach developed by Dorothy E. Smith, builds on Smith’s understanding of the social organization of knowledge, allowing for an examination of the complex social relations organizing people’s experiences of their everyday working lives.

This work thereby makes visible some of the assumptions and hidden priorities underlying the emphasis given to translating scientific knowledge into medical practice. In this study, the discourses of both evidence-based medicine and knowledge translation, purportedly designed to improve patient care, come into view as managerial tools that directed healthcare resources toward academic hospitals rather than community sites where the majority of patients receive care. These models institutionalize inequities in access to care while claiming to resolve them.

About the authors

Fiona Webster is Associate Professor in the Arthur Labatt Family School of Nursing at Western University in London, Ontario, Canada. Webster obtained her PhD in sociology under the supervision of Dorothy E. Smith at the University of Toronto, Canada.

Reviews

‘This book offers a unique critique of evidence based-medicine and how it plays out in everyday practice. It engages with and problematizes the scholarship around “best practice” in an informed and perceptive manner and in doing so, advances the field in a critical way.’

—      Grainne Kearney, Clinical Lecturer in the School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Ireland

‘Webster’s institutional ethnographic research describes how standardizing approaches actually play out in practice. In rich, thick detail we are shown the institutional processes that organize how objective clinical evidence is “rolled out” into the context-laden, deeply social world of healthcare. Offering a unique counter-narrative, the book is illustrative of gaps and risks that may arise when local knowledge is subordinated to coordinated directives from afar.’

—      Janet Rankin, Associate Professor of Nursing, University of Calgary, Canada

Table of contents (7 chapters)

Table of contents (7 chapters)

Buy this book

eBook 58,84 €
price for Spain (gross)
  • ISBN 978-3-030-43165-5
  • Digitally watermarked, DRM-free
  • Included format: EPUB, PDF
  • ebooks can be used on all reading devices
  • Immediate eBook download after purchase
Hardcover 72,79 €
price for Spain (gross)
  • ISBN 978-3-030-43164-8
  • Free shipping for individuals worldwide
  • Immediate ebook access, if available*, with your print order
  • Usually dispatched within 3 to 5 business days.
  • The final prices may differ from the prices shown due to specifics of VAT rules

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Bibliographic Information

Bibliographic Information
Book Title
The Social Organization of Best Practice
Book Subtitle
An Institutional Ethnography of Physicians’ Work
Authors
Copyright
2020
Publisher
Palgrave Macmillan
Copyright Holder
The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG
eBook ISBN
978-3-030-43165-5
DOI
10.1007/978-3-030-43165-5
Hardcover ISBN
978-3-030-43164-8
Edition Number
1
Number of Pages
XI, 127
Number of Illustrations
1 illustrations in colour
Topics

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