Ethnography of "Local Universality": Admission Practices in an Intensive Care Unit Among Guidelines, Routines, and Humour

  • Roberto Lusardi University of Bergamo
Keywords: evidence-based medicine, intensive care, situated practice, humour, ethnography, participant observation, interviews, grounded theory methodology

Abstract

The article analyses the existing gap between the formal dimension of evidence-based medicine (EBM), as constituted by protocols, procedures, and guidelines, and actual professional practices in relation to a specific issue: the admission of patients to an intensive care unit (ICU). The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported. The study was performed using ethnographic methods: participant observation, ethnographic interviews, and semi-structured interviews. Empirical data have been analysed using a grounded theory approach. The results show how three dimensions (macrosocial, organisational-interactional, and individual) become intertwined with the operational guidelines that have been drafted on the basis of international evidence. The standardisation process that the guidelines presuppose results in the adoption of a variety of different local styles with respect to the approach that individual doctors take in relation to the admission of a patient to an ICU. These styles can range from strict adherence to the international criteria to a greater compliance with medical–legal, organisational, and individual needs. Furthermore, the results of the study demonstrate how relational knowledge, as a form of situated knowledge, can allow the personnel involved to activate local resources (organisational, professional, and personal) in order to incorporate the formal prescriptions of EBM in professional practice.

URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1502261

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Author Biography

Roberto Lusardi, University of Bergamo

Roberto LUSARDI is research fellow at University of Bergamo (Italy). His main research interests include qualitative research, particularly ethnographic studies and action research. His personal areas of research interest involve medical practice, interprofessional collaboration and organizational sensemaking.

Published
2015-04-26
How to Cite
Lusardi, R. (2015). Ethnography of "Local Universality": Admission Practices in an Intensive Care Unit Among Guidelines, Routines, and Humour. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 16(2). https://doi.org/10.17169/fqs-16.2.2234