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Caring women, shrewd strategies: the organizational dynamics of home health care

The AIDS epidemic is a driving force in the external policy environment, stimulating large-scale changes in health care organizations. Visiting Nurse Associations (VNAs), gendered organizations with a hundred year tradition of caring work in communities, responded to governmental initiatives with structural and functional changes. A case study of the development of the AIDS Care Program of the Visiting Nurse Service of New York (VNSNY) offers a unique opportunity to explore the exercise of strategy as health policy is translated into organizational practice. Adoption of a gendered analysis is essential to this exploration of internal organizational choice and limits in responding to external societal change.VNSNY, one of the oldest and largest home care agencies in the United States, is located in an epicenter of the AIDS epidemic. Using organizational strategies developed over its history, this agency responded to the city's request for coordinated home care services to people with AIDS. The resulting program implementation and development process demonstrated the coercive state and mimetic professional forces on the organizational structure and function. At the same time VNSNY actively exerted its own influence to regain autonomy lost in previous government contracting. [...]

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Key Information

Type of Reference
Yale university
Resource Database
Publication Year
Start Page
276 p-276 p