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The New Zealand (NZ) government has prescribed a goal for health care at all levels to be patient-centred. Patient-centred care is recognised as an ‘approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among healthcare providers, patients, and families’ (Institute for Patient- and Family-Centred Care). It is a commitment to returning the power to the patient, not the health care system. Presently it is unknown the extent to which the existing health care systems in NZ supports or suppresses the ability to provide care which is patient-centred.
The aim of this project is to examine if NZ health care has a real intent towards and an understanding of what changes are required to support genuinely patient-centred care. This project will use Institutional Ethnography (IE) to explore the power and textual coordination present in the current health care structure that impacts on patient-centred care, to discover how things really work, and attempt to answer the question; what will help or hinder NZ achieving patient-centred care?
IE describes and tracks peoples work, seeking out empirical links, which are then able to be explicated to unravel the invisible, taken-for-granted, organisation of everyday practice. The IE will begin with the experiences of health service users; exploring their expert knowledge of receiving care, and their everyday work of being a consumer of the NZ health care system. While maintaining the standpoint of the patient, a wider network of health care personnel, texts and documents will be analysed. Through this analysis the project will attempt to illuminate the presence of power and ruling relationships that organise patient-centred behaviours which have not previously been visible.
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