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Scientific article MAY 2019

Coordinating objects of care

Exploring the role of case managers as brokers in cancer patient pathways

Authors:

  • Rikke Aarhus
  • Tine Tjørnhøj-Thomsen
  • Britta Damgaard Tarp
  • Peter Vedsted
  • Rikke Sand Andersen
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Objective
Healthcare systems increasingly make use of case managers to handle organisational complexity. In Danish cancer patient pathways, case managers handle the complexities of cancer diagnostics and treatment while adhering to pathway guidelines. This article explores how case managers handle their various responsibilities and focuses on the micro-politics of case management.

Methods
An ethnographic study was carried out in three Danish cancer patient pathways. Interactions between patients and healthcare professionals were observed, including professionals with case management tasks. We interviewed 13 cancer diagnostic patients in their homes and 26 healthcare professionals during work hours, among other things about case management.

Results
We found that the work of case managers differs between cancer patient pathways and settings but overall emphasises coordination of patient trajectories and being contact person. We argue that case managers, embodying the figure of the broker, handle their responsibilities by coordinating the following co-existing objects of care, each with different goals: the diseased body, the person, the organisation and the cancer patient pathway.

Conclusion
We conclude that case managers, in addition to being a response to the complexity of healthcare services, impact the implementation of cancer patient pathways and influence cancer diagnostic activities.

Authors

  • Rikke AarhusTine Tjørnhøj-ThomsenBritta Damgaard TarpPeter VedstedRikke Sand Andersen

About this publication

  • Published in

    European Journal of Cancer Care
VIVE – The Danish Centre for Social Science Research provides knowledge that contributes to developing the welfare society and strengthening quality development, efficiency enhancement and governance in the public sector, both in municipalities, regions and nationally.
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