Marlot Kuiper

57 Standardization in professional settings and their implications for professional practice will be further explored in paragraph 2.4 on ‘Professionals and standards’. First, some further clarification of procedural standards is necessary. Table 2: Definitions and taxonomy of standards 7 Standardization “A process of constructing uniformities across time and space, through the generation of agreed upon rules” Standard “The outcome of standardization” Procedural standards Procedural and performance standards aim to intervene in healthcare practices by defining processes or outcomes. Performance standards Example procedural standard: decubitus screening protocol, Surgical Safety Checklist Example performance standard: Amount of surgeries to be performed, adherence to guidelines and checklists 2.3.2 The ‘jungle’ of procedural standards Now that I have narrowed down the scope of standards, what is left is a ‘jungle’ of procedural standards. The category of procedural standards – standards that define work processes – inhabits a whole wide range of standards in itself. Procedural standards are argued to have in common that they are evidence based, can facilitate measurable improvements in quality of care and aid timely diagnosis and treatment to prevent or limit the severity of morbidity (e.g. Arora et al., 2016). The terms ‘guideline’, ‘protocol’ ‘checklist’, and ‘algorithm’ are often used interchangeably. These types of procedural standards however, differ for example in their scope, the sort of practice they aim to standardize, and consequently, the ‘rigidity’ of their prescription. Medical guidelines for example, aim to ‘‘ assist practitioners in their decision making’’ (Institute of Medicine (U.S.). Committee on Clinical Practice Guidelines, 1992, p. 27, emphasis added). Evidence Based Medicine (EBM) aims to assist practitioners in translating an overwhelming bulk of scientific evidence into practice and standardize decisions medical doctors have to make regarding clinical intervention. These guidelines are a help to professionals and literally ‘guide’ them through clinical decision making. Since guidelines ‘assist’ and not so much prescribe, they can be identified as ‘loose standards’ (Davidoff, 2010). 7 Informed by Timmermans and Berg (2003:24-26), Bowker and Starr (1999) 2