BackgroundThere is an increased interest in the role artists can play in care for older people. This momentum comes with the need to closer investigate the nature of boundary work of creative... Show moreBackgroundThere is an increased interest in the role artists can play in care for older people. This momentum comes with the need to closer investigate the nature of boundary work of creative professionals in arts and health projects.MethodsWe conducted a responsive evaluation to provide a thick description of the boundary work involved in ENCOUNTER#9, an intergenerational arts project taking place within an older person care setting.ResultsBoundary work proved to be rewarding, yet messy and unruly. Although the lead artist had carefully planned and prepared the project and gained a broad commitment, not everything went according to plan. This led to friction and all involved put effort into adjusting goals and expectations.ConclusionWe add to the conceptualisation of boundary work in arts and health by showing that it takes place on different levels: personal, relational, organisational and public. Show less
The conditional cash transfer programme Bono de Desarrollo Humano in Ecuador has allowed the increase in coverage of the social protection system to families in a situation of poverty, drawing... Show moreThe conditional cash transfer programme Bono de Desarrollo Humano in Ecuador has allowed the increase in coverage of the social protection system to families in a situation of poverty, drawing attention to care activities for human capital for- mation. Although women have gained more visibility and have been included in a significant way under this scheme, their inclusion has not resulted in a ruptu- re of traditional gender roles in the household and society. In what ways can we re-imagine non-contributory social protection to reduce gender gaps and include women in a meaningful and transformative way? This article addresses this question by means of an institutional discussion of the hindrances of the current de- sign and invites a consideration of alternatives aimed at framing a new politics of distribution guided by a right-based rationale and rupture of the normative elements that confine women to the care of the household.El programa de transferencias monetarias condicionadas Bono de Desarrollo Humano en Ecuador ha permitido extender la cobertura del sistema de protec- ción social a familias en situación de pobreza, dando relevancia a las labores de cuidado en la construcción de capital humano. A pesar de que las mujeres han ganado mayor visibilidad y han sido incluidas de manera significativa bajo es- te esquema, su inserción no ha generado rupturas con asignaciones tradiciona- les de género dentro del hogar y la sociedad. ¿De qué manera puede reimaginar- se la protección social no contributiva para reducir las brechas de género e incluir de manera significativa y transformativa a las mujeres? El presente artículo abor- da esta pregunta con una discusión institucional de los limitantes del diseño ac- tual e invita a evaluar alternativas encaminadas hacia una nueva política de distri- bución guiada por una lógica de derechos y ruptura con los elementos normativos que relegan a la mujer al cuidado del hogar. Show less
Navarro-Compan, V.; Smolen, J.S.; Huizinga, T.W.J.; Landewe, R.; Ferraccioli, G.; Silva, J.A.P. da; ... ; Heijde, D. van der 2015
Background: Despite the widespread use of quality improvement collaboratives (QICs), evidence underlying this method is limited. A QIC is a method for testing and implementing evidence-based... Show moreBackground: Despite the widespread use of quality improvement collaboratives (QICs), evidence underlying this method is limited. A QIC is a method for testing and implementing evidence-based changes quickly across organisations. To extend the knowledge about conditions under which QICs can be used, we explored in this study the applicability of the QIC method for process redesign. Methods: We evaluated a Dutch process redesign collaborative of seventeen project teams using a multiple case study design. The goals of this collaborative were to reduce the time between the first visit to the outpatient's clinic and the start of treatment and to reduce the in-hospital length of stay by 30% for involved patient groups. Data were gathered using qualitative methods, such as document analysis, questionnaires, semi-structured interviews and participation in collaborative meetings. Results: Application of the QIC method to process redesign proved to be difficult. First, project teams did not use the provided standard change ideas, because of their need for customised solutions that fitted with context-specific causes of waiting times and delays. Second, project teams were not capable of testing change ideas within short time frames due to: the need for tailoring changes ideas and the complexity of aligning interests of involved departments; small volumes of involved patient groups; and inadequate information and communication technology (ICT) support. Third, project teams did not experience peer stimulus because they saw few similarities between their projects, rarely shared experiences, and did not demonstrate competitive behaviour. Besides, a number of project teams reported that organisational and external change agent support was limited. Conclusions: This study showed that the perceived need for tailoring standard change ideas to local contexts and the complexity of aligning interests of involved departments hampered the use of the QIC method for process redesign. We cannot determine whether the QIC method would have been appropriate for process redesign. Peer stimulus was non-optimal as a result of the selection process for participation of project teams by the external change agent. In conclusion, project teams felt that necessary preconditions for successful use of the QIC method were lacking. Show less
