Abstract
This article explores the interplay between different types of knowledge and rationality in care work through a case study of a nursing home innovation project in a Danish municipality. The aim is to understand the implications for innovation processes and dissemination within the context of elder care. Care work, in some sense, relies on relational and contextual knowledge which may lead to challenges when innovation and best practices are to be diffused across organizations. This is especially true since diffusion often relies on codification of practices and knowledge. Caring rationality is essential to how technologies and methods are practiced in the care situation, and thus also essential for best practices and how they are disseminated. However, other types of codified and explicit rationality are equally important. The article concludes that there are several types of knowledge in play in care work practices and innovation, and it indicates that communities of practice could be key to understanding how to share and learn from best practices across organizations.
Highlights
In Scandinavian welfare states, elder care is a core welfare domain which, to a large extent, is provided by the public sector (Daly & Lewis, 2000)
This has been discussed by investigating the knowledge and rationality at play in daily practice and innovation processes in care work in nursing homes
The article argues that understanding the knowledge and rationality at play in innovation processes is key to understanding conditions for the dissemination of innovation in care work, as the local context and identity is important for participants’ willingness to adopt innovations
Summary
In Scandinavian welfare states, elder care is a core welfare domain which, to a large extent, is provided by the public sector (Daly & Lewis, 2000). From a perspective of dissemination of practices across organizations or local contexts, not understanding the specifics of care work could create tensions between the contextuality of innovation practices and the requirement for codification and explication of these This schism is explored in the article through a study and discussion of how different types of knowledge and rationality play out in care work practice and what it means for innovation processes. Davies (1995) argues that care work is characterized by flexibility of response to what is required in the situation, where nothing is predictable in advance and care is ‘committed attending’ which cannot be translated into a set of specific and identifiable tasks Her view represents an understanding of care that challenges dichotomous thinking, counterposing the head with the heart and rationality with emotion. Some argue that values of equal treatment, impartiality, predictability and fairness in the handling of cases, alongside a concern for due process, are important in the public sector (du Gay, 2008), putting a limit on the scope of the ethics of care and opening an additional dimension to be balanced in the daily practice of care work
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