Cancer Pathways in a Psychosocial Perspective: Effects on Professional Roles and Patient Experience (Kræftpakker)
In recent years Danish cancer treatment has undergone radical organizational changes, not least through the introduction of cancer pathways for all cancer diagnoses throughout 2008 and 2009. It is generally agreed that the pathway model is now well-implemented and have succeeded in reducing the waiting times from referral to treatment considerably (Vinge et al. 2012; Larsen 2012; Danske Regioner 2013). Be that as it may, our knowledge about other types of effects is still minimal – not least when it comes to the more psycho-social aspects of the pathway model’s meeting with clinical practice. The current project therefore investigates how an increased focus on for instance time, process, standardization and coordination has redefined and reorganized professional roles and responsibilities with possible effects on patient-relations and patient experiences. As such, the project aims to test the assumption that cancer pathways are not only reorganizing healthcare in relation to efficiency and standardization of treatment, but also in ways that are likely to redistribute competences, to affect ongoing negotiations of professional and patient identities, to redraw boundaries between individualized and standardized treatment as well as to affect the patients’ ability to cope (for instance with the shorter time-spans of treatment steps). These are all issues that may influence the general patient experience and satisfaction. The project enquires into two particular cancer pathways; namely the pathway for ovarian cancer and the pathway for head-neck cancer. These pathways are chosen, among other things, from criteria concerning differences in relation to the ‘smoothness’ of the implementation process as well as with a view to their different patient-groups. Empirically, the research is conducted at several clinics at Copenhagen University Hospital (Rigshospitalet) and it consists of qualitative interviews with physicians and patients as well as observational studies of physician-patient consultations. From an analytical perspective the project combines theoretical approaches primarily within organization studies, medical sociology and literature on professional ethics.