What orients staff in daily care delivery? An ethnographic study

Abstract

This paper discusses the text-mediated coordination of care in the local setting of residential aged care. This study focuses on the identification of the ‘local text’ in daily care delivery and its main characteristics. This research is based on the fieldwork of an ethnographic project of residents’ lived experiences in residential care facilities. Using ethnographic materials, the author explores the text-act relation in care activities within a theoretical framework of Institutional Ethnography. This work aims to reveal what orients staff in daily care delivery and what makes the local text meaningful. Findings from this study demonstrate, when the residents’ preferences and personal needs were made into the local ‘task-sheets’, the person-centred care ideal could be made real in the smooth flow of care activities. To implement evidence-based policy in local setting, the working of the local text and its meaning to daily care delivery need to be understood. Instead of spending a disproportional amount of staff-time on care plans which are not meaningful in the local, more resources need to be allocated to the development of person-centred and integrated local text.