Standards – in the form of guidelines, protocols, scoring instruments, and so forth – are all around us. They are said to have a reverberating influence on our lives and are often assumed to have the natural ability to direct behavior and work. But how standards manage to exert such an influence has rarely been the direct topic of study. This is a surprising knowledge gap because there are many institutional contexts in which standards are explicitly introduced to direct and monitor behaviour and organisational work. One of these contexts is governmental regulation. In her PhD research, Josje Kok takes a close look at the use and enactment of standards in the (governmental) regulation of healthcare.
Her exploration aims to further the academic debate on the workings and consequences of standards as well as help the daily practice of regulation by uncovering how the standards that regulators use produce effects. For regulators understanding these effects is crucial as regulatory bodies are increasingly pressed to demonstrate their societal value and to account for the effectiveness of their work.
Every standard carries a unique story
Kok’s thesis, ‘A Standard Story’, specifically presents and discusses the findings from ethnographic fieldwork at the Dutch Health and Youth Care Inspectorate (Inspectie Gezondheidszorg en Jeugd) and numerous hospitals in the Netherlands. Her fieldwork demonstrates that standards do not have the natural ability to regulate behavior or work. Making a standard ‘do’ something, requires continuous maintenance and interpretation work as well as a social organization to embed the standard in. Standards, therefore, all have their own story: they produce unique effects as a result of the relationships and contexts in which they are enacted. Researchers must map these relationships and contexts in order to understand and explain how a standard works and what consequences it has in practice.
Regulators should actively communicate the ‘softer’ parts of their work
The study has practical relevance for the work of a regulator for it shows that standards have an important function for accountability purposes, but by actively showcasing their standards as disciplining and objectifying instruments, the Inspectorate – like any other regulatory body – also risks the public to attain an unrealistic view of regulatory work in the sense that it is framed as an entirely objective, standardized practice. This, as the thesis shows, is not the case. As such Kok recommends that regulatory bodies – particularly in this age of big data and algorithms - think of ways to actively communicate about the ‘softer’ parts of their work, including the relational interpretive work and collective sense-making practices, to the greater public.
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Want to know more about this study? Read the thesis here.
