Tightrope Walking: Standardization Meets Local Work-Practice in a Hospital

Abstract

Traditionally, uniform and standardized IT-solutions in health care are considered mechanisms for increased control, efficiency and quality. Unfortunately, in spite of existing studies of the actual experiences of standardization, such as how they come into being, and how they are intertwined with local practice, unreasonable belief in standardization seems to prevail. Acknowledging the origin of standardization and its local character, however, does not mean that standardization is futile or should be avoided. It rather means that standardization efforts should balance the management level’s need for increased coordination and control, and the local level’s need for flexibility. The aim of this chapter is to strike this balance as it elaborates the implications and the “costs” for local practice in order to make a standard work. Empirically, the chapter draws on a standardization effort of discharge letter production in the University Hospital of Northern Norway.