Bedtime negotiations: Unravelling normative complexity in hospital-based prevention

Area of Science:

• Healthcare Management
• Sociology of Health
• Preventative Care Implementation

Background:

• Conflicting valuations of preventative care exist within healthcare systems.
• Limited empirical research addresses how these conflicts are resolved in daily practice.
• Normative complexity arises during the implementation of preventative care initiatives.

Purpose of the Study:

• To explore how actors manage normative complexity in designing and implementing preventative care practices.
• To describe the resolution of conflicting valuations of prevention in day-to-day healthcare interactions.
• To analyze the strategies used by a Dutch psychiatrist developing a novel hospital bed for preventative psychiatric care.

Main Methods:

• Ethnographic study focusing on a single actor (a Dutch psychiatrist).
• Analysis of the development of a novel hospital bed for post-partum preventative psychiatric care.
• Application of pragmatic sociology of justification to understand the convergence of care valuations.

Main Results:

• Embedded valuation modes in curative settings create significant normative complexity.
• Three strategies for managing normative complexity were identified: translation, compromise in design, and moral appeals.
• The development of the 'care bed' served as a focal point for conflicting care valuations.

Conclusions:

• Implementing preventative care involves navigating complex, often conflicting, normative landscapes.
• Diverse and situated approaches are necessary for effective preventative care accounting.
• Understanding practical strategies for managing normative complexity is crucial for successful healthcare innovation.