Coordinating objects of care: Exploring the role of case managers as brokers in cancer patient pathways

Rikke Aarhus, Tine Tjørnhøj-Thomsen, Britta Tarp, Peter Vedsted, Rikke S Andersen

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

OBJECTIVE: Healthcare systems increasingly make use of case managers to handle organisational complexity. In Danish cancer patient pathways, case managers handle the complexities of cancer diagnostics and treatment while adhering to pathway guidelines. This article explores how case managers handle their various responsibilities and focuses on the micro-politics of case management.

METHODS: An ethnographic study was carried out in three Danish cancer patient pathways. Interactions between patients and healthcare professionals were observed, including professionals with case management tasks. We interviewed 13 cancer diagnostic patients in their homes and 26 healthcare professionals during work hours, among other things about case management.

RESULTS: We found that the work of case managers differs between cancer patient pathways and settings but overall emphasises coordination of patient trajectories and being contact person. We argue that case managers, embodying the figure of the broker, handle their responsibilities by coordinating the following co-existing objects of care, each with different goals: the diseased body, the person, the organisation and the cancer patient pathway.

CONCLUSION: We conclude that case managers, in addition to being a response to the complexity of healthcare services, impact the implementation of cancer patient pathways and influence cancer diagnostic activities.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Cancer Care
Vol/bind28
Nummer3
Sider (fra-til)e13017
ISSN0961-5423
DOI
StatusUdgivet - maj 2019

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