IDEAS home Printed from
   My bibliography  Save this article

Conferences, tablecloths and cupboards: How to understand the situatedness of quality improvements in long-term care


  • Stoopendaal, Annemiek
  • Bal, Roland


Long term care needs improvement, but still little is known how quality improvement works in practice. A better, in-depth, understanding of the content and complexities of quality improvement is necessary because of the still limited theoretical and empirical grounds underlying its approach. This article draws on empirical material from Care for Better, a national quality improvement collaborative (QIC) for the long-term care sector in the Netherlands that took place from 2005 until 2012. Following a project on prevention of malnutrition, we analyzed the complex and ongoing processes of embedding improvements. The guiding question for our research was: what must be accomplished to enable and sustain improvements to occur in the everyday life of care organizations? In our analysis, we linked ethnographic findings to Actor Network Theory. We found that different kinds of work had to be done by both human and non-human actors to displace improvements into specific organizational situations. We conceptualized this work as the activity of translation. Moreover, the concept of inscription offers a perspective to reveal how improvements are made durable. Inscriptions are translations of values into texts, behavior or materialities that steer action in a specific way. We analyzed three different modes of inscription: gathering, materializing and training. We analyzed how one specific value, patient choice, became inscribed in different ways, configuring the actors in specific ways, with diverging consequences for how patient choice comes about.

Suggested Citation

  • Stoopendaal, Annemiek & Bal, Roland, 2013. "Conferences, tablecloths and cupboards: How to understand the situatedness of quality improvements in long-term care," Social Science & Medicine, Elsevier, vol. 78(C), pages 78-85.
  • Handle: RePEc:eee:socmed:v:78:y:2013:i:c:p:78-85 DOI: 10.1016/j.socscimed.2012.11.037

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Dixon, Anna & Robertson, Ruth & Bal, Roland, 2010. "The experience of implementing choice at point of referral: a comparison of the Netherlands and England," Health Economics, Policy and Law, Cambridge University Press, vol. 5(03), pages 295-317, July.
    2. Zuiderent-Jerak, Teun & Strating, Mathilde & Nieboer, Anna & Bal, Roland, 2009. "Sociological refigurations of patient safety; ontologies of improvement and 'acting with' quality collaboratives in healthcare," Social Science & Medicine, Elsevier, vol. 69(12), pages 1713-1721, December.
    3. Greenhalgh, Trisha & Stones, Rob, 2010. "Theorising big IT programmes in healthcare: Strong structuration theory meets actor-network theory," Social Science & Medicine, Elsevier, vol. 70(9), pages 1285-1294, May.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Janssen, M. & Stoopendaal, A.M.V. & Putters, K., 2015. "Situated novelty: Introducing a process perspective on the study of innovation," Research Policy, Elsevier, vol. 44(10), pages 1974-1984.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:78:y:2013:i:c:p:78-85. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.