College aantekeningen
Lecture 5 Q&S
This is a summary and elaboration of lecture 5 Quality and Safety.
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Lecture 5Q&S
Technologies of quality work
Objectives for this week
- Becoming acquainted with three different theoretical perspectives on technology:
o Linguistic perspective
o Cultural perspective
o Processual perspective
- Learning how these perspectives can be applied to the analysis of technologies of
quality and safety in hc
The technological challenge in quality and safety work
“Designing physical infrastructures and technological systems that are supportive of quality
efforts” (Bate et al., 2008)”
- Importance of technological systems to support and govern quality and safety work:
o ICT-systems that support workflow
o Patient-friendly designs of physical infrastructure
o User-friendly design of medical and care equipments
o Preferably decrease of work-load
- But: a sole focus on technology can lead to mechanistic approaches, create work-
arounds and disappointments
Technological culture
- Role of technology not only limited to healthcare - we live in a technological culture
o Technologies are everywhere around us
o Technology and society/culture mutually shape each other (often in
unpredictable ways)
- High expectations vs. intense debate about new technologies
- Implementing and disseminate promising technologies notoriously difficult
- This makes it important to become acquainted with different perspectives on
technologies in general
o Science & Technology Studies (STS)
o Philosophy of technology
How does Microsoft see the future of hc?
- Everyone is (pre-) patient
- Seamless data sharing
- Constant information about health status available
What is missing from this future ideal?
- Older persons who are not technologically savvy
- Poor patients from disadvantaged backgrounds
- Sickness/suffering/despair
- Dysfunctional technology
- Information overload
, - Privacy risks
- Interaction/intimacy
- People who do not want constant surveillance
Ambivalent technologies
- Many ‘hoorah’ stories about new technologies; optimism and high expectations as a
recurring trend
- Alternative voices are also often heard; technology presented in highly negative
terms, critical perspectives on technology (oppressive, dehumanizing)
- With hindsight we often conclude that:
o Expectations (positive and negative) often highly exaggerated
o ‘Revolutionary’ technologies do not become embedded in (healthcare)
practice or get a very different shape
o Even for highly promising technologies implementation and dissemination
remain difficult
Three theoretical perspectives on technology
- Linguistic (rhetorical analysis of technological prophecies)
- Cultural (anthropological theory on ‘purity’ and ‘monsters’)
- Processual (normalization process theory)
Linguistic perspective
- Long history of predictions of technological developments that lead to ‘radical
change’
- Historical analysis of ‘future industry’: prophecies made by trendwatchers, cyber-
goeroes, futurologists and popular science journalists
- Rhetorical analysis of literary ‘genre’ of technological prophecies:
o Common retorical figures
o Metaphors
o Paradoxes
Technological prophecies as literary ‘genre’
- Three questionable patterns of reasoning
o The idea of total revolution (technology will radically change our lives)
o The idea of social contuinty (new technology will solve old problems)
o The notion of a technological ‘fix’ (technology as a panacea for societal and
political problems)
Fix as fixing something
Fix as fixed meaning
- Symbolic meanings and metaphors
o The beckoning future
Future as a new start
Always positive in tone
Promise of more autonomy
Sharp opposition between present and future
o The rushing future
Future is approaching fast
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