Unworkable guidelines.

This paper discusses the effects of restructuring on nursing as a profession through an examination of the issue of complaints in Ontario. It argues that new managerialist techniques and associated changes in the nature of work are reducing the autonomy of nurses and making it difficult for them to meet the standards of their profession. Simultaneously, the Ontario government has increased the power of the public in the disciplinary process and the College of Nurses of Ontario is encouraging patients to register their complaints. The growth of consumerism in health care, coupled with the disciplinary process, individualizes complaints and deemphasizes their relationship to restructuring. Moreover, in response to the increasing number of complaints - complaints which more often come from the public - nursing organizations have encouraged the legalization of the disciplinary process, thus fostering the individualization of the issues.

Consumer Advocacy↗

PubMed1999

Public disclosure of health care performance reports: comments and reflections from Sweden.

In all countries quality improvement is a very important issue. At the same time the demands for information from consumers are increasing. By combining these two principles we can gain a great deal. In my opinion we will go both ways. Bad results, if publicly disclosed, are probably the strongest incentive to improve if they are reliable. Confidential performance feedback for self improvement is the way Sweden is heading at the moment. In the near future, I am sure, we will publish performance reports accompanied by analytic comments regarding quality indicators that are well defined and easy for consumers to evaluate. A pre-condition is that the medical profession must have time to get accustomed. Only experience will show how to devise the most effective means to improve quality and confidence in health care. We will follow the progress in the USA with great interest.

Consumer Advocacy↗