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Recovering the Performative Role of Innovations in the Globasl Travel of Healthcare Practice. Is there a Ghost in the Machine?

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Nicolini D., Mengis J., Meacheam D., Waring J.
Book chapter
This chapter discusses the global travel of practices with reference to the international patient safety movement, focusing on a specific approach to incident investigation (Root Cause Analysis or RCA for short). We assess how knowledge of the technique was mobilized, from the United States to Australia, the United Kingdom and beyond. We argue that the mobilization and world spanning circulation of this set of practices was sustained and facilitated by the construction of an “anxiety-reassurance” package. This package worked to support the mobilization of the approach through, first, raising public and professional anxiety about pre-existing management practices around patient safety, and second, creating reassurance by proposing a new management solution to solve this problem. Playing together these two seemingly opposite discourses, the innovation generated a wave of interest and urgency that it then rode and that allowed rapid globalization. Below we show how this powerful “package” actively translated the new approach in the sense of both circulating and profoundly reconfiguring it. We suggest that a focus on the innovation as a well-oiled piece of discursive machinery helps us “unpack the black box,” and understand the active role of innovations in fueling their own translation. This without reverting to the old idea that innovations are “diffused.”
Mobilizing Knowledge in Healthcare
Oxford University Press
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Innovation, Sociology of Translation, Root Cause Analysis, Performativity