Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care

Unsustainability in health care comprises diminishing returns and misalignment between the health care regime and the needs of the population. To deal with complex sustainability problems, niche solutions can be collaboratively designed and implemented through reflexive methods. For second-order sus...

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Autores principales:	Tjerk Jan Schuitmaker-Warnaar, Callum J. Gunn, Barbara J. Regeer, Jacqueline E. W. Broerse
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	second-order sustainability reflexivity institutionalization perinatal care interprofessional collaboration patient engagement Environmental effects of industries and plants TD194-195 Renewable energy sources TJ807-830 Environmental sciences GE1-350
Acceso en línea:	https://doaj.org/article/789e5c0a1f29455295a1f4cf0af4b009
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spelling	oai:doaj.org-article:789e5c0a1f29455295a1f4cf0af4b0092021-11-11T19:26:21ZInstitutionalizing Reflexivity for Sustainability: Two Cases in Health Care10.3390/su1321117122071-1050https://doaj.org/article/789e5c0a1f29455295a1f4cf0af4b0092021-10-01T00:00:00Zhttps://www.mdpi.com/2071-1050/13/21/11712https://doaj.org/toc/2071-1050Unsustainability in health care comprises diminishing returns and misalignment between the health care regime and the needs of the population. To deal with complex sustainability problems, niche solutions can be collaboratively designed and implemented through reflexive methods. For second-order sustainability, however, the institutionalization of the reflexive element itself is also needed. This paper aims to provide insight into the possibilities of embedding reflexivity into institutions to support second-order sustainability by reporting on two consecutive participatory research programs that sought to address unsustainability in terms of misalignment and diminishing returns. The first case study reflexively monitored the system’s innovation toward an integrated perinatal care system. Reflection within the project and implementation was supported successfully, but for stronger embedding and institutionalization, greater alignment of the reflexive practices with regime standards was needed. Building on these lessons, the second case study, which was part of the IMI-PARADIGM consortium, collaboratively built a structured tool to monitor and evaluate “the return on engagement” in medicine development. To institutionalize reflexivity, the creation of “reflexive standards” together with regime actors appears to be most promising. Broader and deeper institutionalization of reflexive standards can be attained by building enforcement structures for reflexive standards in the collaborative process as part of the reflexive methodologies for addressing complex sustainability problems.Tjerk Jan Schuitmaker-WarnaarCallum J. GunnBarbara J. RegeerJacqueline E. W. BroerseMDPI AGarticlesecond-order sustainabilityreflexivityinstitutionalizationperinatal careinterprofessional collaborationpatient engagementEnvironmental effects of industries and plantsTD194-195Renewable energy sourcesTJ807-830Environmental sciencesGE1-350ENSustainability, Vol 13, Iss 11712, p 11712 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	second-order sustainability reflexivity institutionalization perinatal care interprofessional collaboration patient engagement Environmental effects of industries and plants TD194-195 Renewable energy sources TJ807-830 Environmental sciences GE1-350
spellingShingle	second-order sustainability reflexivity institutionalization perinatal care interprofessional collaboration patient engagement Environmental effects of industries and plants TD194-195 Renewable energy sources TJ807-830 Environmental sciences GE1-350 Tjerk Jan Schuitmaker-Warnaar Callum J. Gunn Barbara J. Regeer Jacqueline E. W. Broerse Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
description	Unsustainability in health care comprises diminishing returns and misalignment between the health care regime and the needs of the population. To deal with complex sustainability problems, niche solutions can be collaboratively designed and implemented through reflexive methods. For second-order sustainability, however, the institutionalization of the reflexive element itself is also needed. This paper aims to provide insight into the possibilities of embedding reflexivity into institutions to support second-order sustainability by reporting on two consecutive participatory research programs that sought to address unsustainability in terms of misalignment and diminishing returns. The first case study reflexively monitored the system’s innovation toward an integrated perinatal care system. Reflection within the project and implementation was supported successfully, but for stronger embedding and institutionalization, greater alignment of the reflexive practices with regime standards was needed. Building on these lessons, the second case study, which was part of the IMI-PARADIGM consortium, collaboratively built a structured tool to monitor and evaluate “the return on engagement” in medicine development. To institutionalize reflexivity, the creation of “reflexive standards” together with regime actors appears to be most promising. Broader and deeper institutionalization of reflexive standards can be attained by building enforcement structures for reflexive standards in the collaborative process as part of the reflexive methodologies for addressing complex sustainability problems.
format	article
author	Tjerk Jan Schuitmaker-Warnaar Callum J. Gunn Barbara J. Regeer Jacqueline E. W. Broerse
author_facet	Tjerk Jan Schuitmaker-Warnaar Callum J. Gunn Barbara J. Regeer Jacqueline E. W. Broerse
author_sort	Tjerk Jan Schuitmaker-Warnaar
title	Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
title_short	Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
title_full	Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
title_fullStr	Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
title_full_unstemmed	Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care
title_sort	institutionalizing reflexivity for sustainability: two cases in health care
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/789e5c0a1f29455295a1f4cf0af4b009
work_keys_str_mv	AT tjerkjanschuitmakerwarnaar institutionalizingreflexivityforsustainabilitytwocasesinhealthcare AT callumjgunn institutionalizingreflexivityforsustainabilitytwocasesinhealthcare AT barbarajregeer institutionalizingreflexivityforsustainabilitytwocasesinhealthcare AT jacquelineewbroerse institutionalizingreflexivityforsustainabilitytwocasesinhealthcare
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Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care

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