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How might organisational institutionalism support the challenges of the modern hospice?

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  • Emma Hodges
  • Sue Read

Abstract

The external environment within which UK charitable hospice care operates is changing. More people are dying with conditions other than cancer; however, this disease still dominates modern hospice care. Organisational institutionalism offers a theoretical lens through which to consider the challenges facing the hospice movement. Concepts such as legitimacy, decoupling, deinstitutionalisation, and reinstitutionalisation can help hospice leaders understand the challenges of change and some of the strategies that can be employed at local and national levels. This paper outlines a number of environmental and influencing factors driving and impacting change. A model of institutional change is introduced, explored, and considered from the context of hospice. When it comes to understanding change, legitimacy is a major concept introduced to challenge and pose questions for hospices to address. This paper proposes a model demonstrating a perspective regarding the current structure of services within hospice organisations. The model argues that only hospice care for people with cancer is truly institutionalised and that other areas of care lack comparable legitimacy. It provides 3 directions for hospice in addressing the challenges faced: (i) decoupling, (ii) deinstitutionalisation then reinstitutionalisation, and (iii) a new social movement. The paper concludes with recommendations for future consideration.

Suggested Citation

  • Emma Hodges & Sue Read, 2018. "How might organisational institutionalism support the challenges of the modern hospice?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(4), pages 768-774, October.
  • Handle: RePEc:bla:ijhplm:v:33:y:2018:i:4:p:768-774
    DOI: 10.1002/hpm.2556
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    Cited by:

    1. Boštjan Kušar & Dragica Maja Smrke & Mojca Bernik, 2019. "Slovenian health care system and possibilities for freelance medical specialists," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1109-1120, October.
    2. Mæhle, Per Magnus & Smeland, Sigbjørn, 2021. "Implementing cancer patient pathways in Scandinavia how structuring might affect the acceptance of a politically imposed reform," Health Policy, Elsevier, vol. 125(10), pages 1340-1350.
    3. Per Magnus Mæhle & Senada Hajdarevic & Erna Håland & Rikke Aarhus & Sigbjørn Smeland & Bjørn Erik Mørk, 2021. "Exploring the triggering process of a cancer care reform in three Scandinavian countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2231-2247, November.

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