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Financialising acute kidney injury: From the practices of care to the numbers of improvement

Bailey, Simon, Pierides, Dean, Brisley, Adam, Weisshaar, Clara, Blakeman, Tom (2019) Financialising acute kidney injury: From the practices of care to the numbers of improvement. Sociology of Health and Illness, 41 (5). pp. 882-899. ISSN 0141-9889. (doi:10.1111/1467-9566.12868) (Access to this publication is currently restricted. You may be able to access a copy if URLs are provided)

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Abstract

Although sociological studies of quality and safety have identified competing epistemologies in the attempt to measure and improve care, there are gaps in our understanding of how finance and accounting practices are being used to organise this field. This analysis draws on what others have elsewhere called ‘financialisation’ in order to explore the quantification of qualitatively complex care practices. We make our argument using ethnographic data of a quality improvement program for acute kidney injury (AKI) in a publicly funded hospital in England. Our paper is thus concerned with tracing the effects of financialisation in the emergence and assembly of AKI as an object of concern within the hospital. We describe three linked mechanisms through which this occurs: (1) representing and intervening in kidney care; (2) making caring practices count; and, (3) decision-making using kidney numbers. Together these stages transform care practices first into risks and then from risks into costs. We argue that this calculative process reinforces a separation between practice, and organisational decision-making made on the basis of numbers. This elevates the status of numbers while diminishing the work of practitioners and managers. We conclude by signalling possible future avenues of research that can take up these processes.

Item Type: Article
DOI/Identification number: 10.1111/1467-9566.12868
Uncontrolled keywords: Financialisation; quality improvement; quantification; care practices; acute kidney injury
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Bailey
Date Deposited: 10 Dec 2018 13:54 UTC
Last Modified: 26 Sep 2019 09:15 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/70902 (The current URI for this page, for reference purposes)
Bailey, Simon: https://orcid.org/0000-0001-9142-2791
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