Beyond Patient Pathways

How is care coordinated when the course is uncertain, the work distributed, and the patient constantly redefined? In this detailed ethnographic study of the hip fracture trajectory, we challenge the dominant rational-linear logic of care pathways to reveal the complex, evolving assemblages that underpin everyday service delivery.

Davina Allen is a professor of Health Service Organisation and Delivery at Cardiff University. A nurse and a sociologist, her work spans foundational ethnographic studies, applied research, and theory development. A Fellow of the Academy of Social Sciences, the Learned Society of Wales, and the Health Foundation, she has a longstanding commitment to the value of sociological inquiry to illuminate and address the practical challenges of contemporary healthcare systems.

Part 1: Reframing Coordination, Introduction to Part 1, 1: The Trouble with Coordination: Organisational Challenges and the Seductions of Pathways, 2: Reimagining Coordination: Sociological Perspectives, 3: Studying Coordination in the Wild: Case, Methods, and Theoretical Framework, Part 2: The Provisional Patient - The Unscheduled Care Assemblage.Introduction to Part 2, 4: Calls, Codes, Dispatch: Emergency Medical Services Control Centre Work, 5: Between Crisis and Care: Emergency Medical Services Responder Work, 6: From Arrival to Admission: Emergency Department Work, 7: Evolving Objects: Unscheduled Care Transitions, Summary of Part 2, Part 3: The Definitive Patient - The Acute Care Assemblage, Introduction to Part 3, 8: Assessment and Alignment: Preoperative Orthogeriatric Work, 9: Bodies and Materials: Operating Department Work, 10: Conscripted Objects: Acute Care Transitions, Summary of Part 3, Part 4: The Distributed Patient - The Recovery Care Assemblage, Introduction to Part 4, 11: Recovery and Discharge Planning: Postoperative Orthogeriatric Work, 12: Enablement and Infrastructures: Community Resource Team Work, 13: Unstable Objects: Recovery Care Transitions, Summary of Part 4, Conclusion: Trajectory Assemblage Synthesis and Implications for Service Improvement and Research, 14: Beyond Pathways: Making Coordination Work