Paper long abstract:

In recent years themes of coherence and coordination across organizational boarders has become increasingly important in healthcare quality work. This is among other things reflected in a variety of technologies within the very broad topic of 'quality development' developed in order to support coordination and coherence. Some of these technologies are closely linked to scientific work showing a close relation between quality and coordination, others are related to public debates addressing patient's right to linear, fast and coherent trajectories of care. Either way these technologies are intended to impact not only one but several local configurations of work in the healthcare institutions. STS offers many insights to the understanding of the co-existence of ambiguities and to the creation of order in otherwise incoherent settings. Among these are also studies that show how new schemes of action unintentionally can disturb some parts of an already existing order while supporting another. Hence, technologies of coherence can be perceived as a potential threat to its own intentions - not the least because of their multi-sited nature - and propose a new and additional challenges to the establishment of coherence.

This apparent paradox of coherence is investigated through an analysis based on an ethnographic field work. The fieldwork took place at two hospital departments in a Danish Hospital. In this fieldwork the work of the two quality coordinators were observed focusing on their efforts to combine and embed the ordering of work of delineated organizational units within the orderings offered by the technologies of coherence.