How Hospitals Work: New Understandings Using Practice Theory

Area of Science:

• Health Services Research
• Sociology of Health
• Organizational Studies

Background:

• Improving hospital healthcare delivery is a key challenge for policymakers, managers, and clinicians.
• Conventional improvement strategies often focus narrowly on either systems or individual behaviors.
• Social practice theory presents an alternative framework for understanding complex hospital operations.

Purpose of the Study:

• To explore how social practice theory can offer novel insights into hospital improvement.
• To move beyond binary understandings of healthcare delivery by examining underlying practices.
• To identify specific elements supporting or hindering effective healthcare practices within hospitals.

Main Methods:

• Analysis of two distinct hospital case studies.
• Application of social practice theory principles to understand healthcare delivery.
• Examination of practices, competencies, meanings, and infrastructure.

Main Results:

• Practice theory reveals how specific practices influence healthcare outcomes.
• Identified how competencies, meanings, and infrastructure enable or constrain practices.
• Demonstrated how modifying linkages supporting practices can alter outcomes.

Conclusions:

• Social practice theory provides a more nuanced understanding of hospital functioning.
• This theoretical approach facilitates the development of targeted interventions for healthcare improvement.
• Understanding and strengthening supportive linkages for key practices is crucial for enhancing hospital care.