(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare

Document Type: Editorial

Authors

Health Services Management Centre, University of Birmingham, Birmingham, UK

Abstract

Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by ‘standardization’ and ‘customization’ in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics – the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery.

Highlights

Commentaries Published on this Paper

  • Personalisation - An Emergent Institutional Logic in Healthcare?; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

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  • It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare; Comment on “(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare”

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  • Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

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  • Best of Both Worlds; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

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  • Competing Logics and Healthcare; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

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  • Toward Customized Care; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

          Abstract | PDF

 

Authors’ Response to the Commentaries

  • Researching the Co-Existence and Continuity of Standardization and Customization in Healthcare: A Response to Recent Commentaries

          Abstract | PDF

Keywords

Main Subjects


  1. Reay T, Hinings C. Managing the rivalry of competing institutional logics. Organ Stud. 2009;30(6):629-652. doi:10.1177/0170840609104803
  2. Pfaff H, Driller E, Ernstmann N, et al. Standardization and Individualization in Care for the Elderly: Proactive Behavior Through Individualized Standardization. Open Longev Sci. 2010;4:51-57
  3. Leotsakos A, Zheng H, Croteau R,et al.Standardization in patient safety: the WHO High 5s project. Int J Qual Health Care. 2014;26(2):109-116. doi:10.1093/intqhc/mzu010
  4. Espeland WM,  Sauder M. Rankings and reactivity: how public measures recreate social worlds. Am J Sociol. 2007;113(1):1–40.
  5. Koyama J, Kania B. When transparency obscures: the political spectacle of accountability. Journal of Critical Education Policy Studies. 2014;12(1):143-169.
  6. Timmermans S, Epstein A. A world of standards but not a standard world: toward a sociology of standards and standardization. Ann Rev Sociol. 2010;36:69-89. doi: 10.1146/annurev.soc.012809.102629
  7. 7Timmermans S, Almeling A. Objectification, standardization, and commodification: a conceptual readjustment and research agenda. Soc Sci Med. 2009;69:21-27.
  8. Gawande A. The checklist manifesto: how to get things right. New York: Metropolitan Books-Hdentry Holt and Company; 2009.
  9. Exworthy M. The iron cage and the gaze: interpreting medical control in the English health system. Professions and Professionalism. 2015;5(1):1-14. doi:10.7577/pp.944
  10. Power M. The Audit Society: Rituals of Verification. Oxford: Oxford University Press; 1997.
  11. Flynn R. Clinical governance and governmentality. Health Risk Soc. 2012;4(2):155–173.
  12. Dopson S, Fitzgerald L, eds. Knowledge to Action: Evidence-Based Health Care in Context. Oxford: Oxford University Press; 2005.
  13. Jones L, Exworthy M. Framing in policy processes: A case study from hospital planning in the National Health Service in England. Soc Sci Med. 2015;124:196-204. doi:10.1016/j.socscimed.2014.11.046
  14. Gabbay J, le May A. Practice-Based Evidence for Healthcare: Clinical Mindlines. London: Routledge; 2011.
  15. Timmermans S, Berg M. Standardization in action: achieving local universality through medical protocols. Soc Sci Med. 1997;2:273-305.
  16. Exworthy M, Wilkinson EK, McColl A, et al.The role of performance indicators in changing the autonomy of the general practice profession in the UK. Soc Sci Med. 2003;56(7):1493-1504.
  17. McDonald R, Waring J, Harrison S. Rules, safety and narrativisation of identity: a hospital operating theatre case study. Sociol Health Illn. 2006;28(2):178-202.
  18. Waring J, Allen D, Braithwaite J, Sandal J. Healthcare quality and safety: a review of policy, practice and research. In: Allen D, Braithwaite J, Sandall J, Waring J, eds. The Sociology of Healthcare Safety and Quality. Chichester: Wiley Blackwell Publishing; 2016.
  19. Debono D, Greenfield D, Black D, Braithwaite J. Achieving and resisting change: workarounds straddling and widening gaps in health care. In: Dickinson H, Mannion R, eds. The Reform of Health Care: Shaping, Adapting and Resisting Policy Developments, Basingstoke: Palgrave-Macmillan; 2012:177-192.
  20. Runciman B, Merry A, Walton M. Safety and Ethics in Healthcare: A Guide to Getting it Right. Hampshire: Ashgate Publishing Limited; 2007.
  21. Halbesleben J, Wakefield D, Wakefield B. Work-arounds in health care settings: literature review and research agenda. Health Care Manage Rev. 2008;33(1):2-12.
  22. Austin W. Against Compassion: Understanding Institutional Perfidy as Evil. http://www.inter-disciplinary.net/wp-content/uploads/2011/04/waustinpaper.pdf. Accessed  March 4, 2017. Published 2011.
  23. Mannion R, Braithwaite J. Unintended consequences of performance measurement in healthcare: 20 salutary lessons from the English National Health Service. Intern Med J. 2012;42(5):569-574.
  24. Francis R. The Mid Staffordshire NHS Foundation Trust Public Inquiry. London: Stationery Office; 2013.
  25. Minvielle E, Waelli M, Sicotte C, Kimberley J. Managing customization in health care: a framework derived from the services sector literature. Health Policy. 2014;117(2):216-227. doi:10.1016/j.healthpol.2014.04.005
  26. Hamburg M, Collins F. The path to personalized medicine. N Engl J Med. 2010;363:301-304. doi:10.1056/NEJMp1006304
  27. Oshima-Lee E, and Ezekiel EJ. Shared decision making to improve care and reduce costs. N Engl J Med. 2013;368(1):6-8. doi:10.1056/NEJMp1209500.
  28. Forster R, Gabe J. Voice or choice’? Patient and public involvement in the National Health Service in England under new labour. Int J Health Serv. 2008;38(2):333-356.
  29. Needham C, Glasby J. Debates in Personalisation. Bristol: Policy Press; 2014.
  30. Newman J, Clarke J. Public, Politics and Power. London: Sage; 2009.
  31. Cutler T, Waine B, Brehony K. A new epoch of individualization? Problems with the personalization of public services. Public Adm. 2007;85(3):847-855.
  32. Thornton P, Ocasio W. Institutional logics and the historical contingency of power in organizations: executive succession in the higher education publishing industry, 1958–1990.  Am J Soc. 1998;105(3):801-843.
  33. Mannion R, Davies H. Cultures in Healthcare. In: Ferlie E, Montgomery K, Reff Pedersen A, eds. Oxford Handbook of Health Care Management. Oxford: Oxford University Press; 2016.
  34. Lampel J, Mintzberg H. Customizing customization. Sloan Management Review. 1996. http://sloanreview.mit.edu/article/customizing-customization/.
  35. Gilmore JH, And Opine BJ. The four faces of mass customisation. Harv Bus Rev. 1997;75(1):91-101.
  36. Olakivi A, Niska M.  Rethinking managerialism in professional work: from competing logics to overlapping discourses. Journal of Professions and Organization. 2017;4(1):20-35. doi:10.1093/jpo/jow007.
  37. Kirkpatrick I, Ackroyd S. Transforming the professional archetype? The new managerialism in UK social services. Public Management Review. 2003;5(4):511-531.
  38. Scott RW. Lords of the dance: professionals as institutional agents. Organ Stud. 2008;29(2):219-238.
  39. Dugdale A. Materiality: juggling sameness and difference. Sociol Rev. 1999;47(S1):113-135.
  40. Currie G,  Spyridonidis D. Interpretation of multiple institutional logics on the ground: actors' position, their agency and situational constraints in professionalized contexts. Organ Stud. 2015;37(1):77-97.
  41. Martin G, Currie G, Weaver S, Finn R,  McDonald R. Institutional complexity and individual responses: delineating the boundaries of partial autonomyOrgan Stud. 2017;38(1):103-127. doi:10.1177/0170840616663241