Hospital pharmacy automation: collective mobility or collective control?

This study examines the relationship between new technology and pharmacy's changing role in the division of labour in health care. Does automation advance pharmacy's collective mobility project and transition to its new role as a clinical rather than a merely technical profession? Alternatively, does it threaten pharmacy's cultural authority and control of medication dispensing? Does technology serve as an artifact demarcating occupational and gender boundaries in the drug distribution labour process? These issues were examined through qualitative case studies conducted at three hospital pharmacies located in mid-sized Canadian health care facilities. All three institutions had implemented automated drug distribution technology in the expectation that it would allow more pharmacist's time to be shifted from dispensing-related to clinical activities. It was found that pharmacists had attempted to maintain control of their labour process and had resisted peripheralization from drug dispensing. Technological processes did serve as artifacts reinforcing occupational demarcations as well as professional solidarity vis a vis hospital administrators although its impact on gender boundaries was less evident.

[1]  Samuel B. Bacharach,et al.  Research in the Sociology of Organization. , 1994 .

[2]  C. D. Hepler.  The third wave in pharmaceutical education: the clinical movement. , 1987, American journal of pharmaceutical education.

[3]  Christine E. Bose,et al.  Ingredients for women's employment policy , 1988 .

[4]  W. Bottero.  The Changing Face of the Professions? Gender and Explanations of Women's Entry to Pharmacy , 1992 .

[5]  N E Kawahara,et al.  Influencing prescribing behavior by adapting computerized order-entry pathways. , 1989, American journal of hospital pharmacy.

[6]  G. Ritzer,et al.  Rationalization and the Deprofessionalization of Physicians , 1988 .

[7]  Patricia A. Roos,et al.  Job Queues, Gender Queues , 1990 .

[8]  A. Lewis.  The Deskilling Thesis Revisited: On Peter Armstrong's Defence of Braverman , 1995 .

[9]  M. Greer,et al.  A survey of selected issues involving pharmacy technician training in Canada. , 1993, The Canadian journal of hospital pharmacy.

[10]  J. E. Ness,et al.  Accuracy of technicians and pharmacists in identifying dispensing errors. , 1994, American journal of hospital pharmacy.

[11]  K N Barker,et al.  Ensuring safety in the use of automated medication dispensing systems. , 1995, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[12]  G. Schiff,et al.  Computerized prescribing: building the electronic infrastructure for better medication usage. , 1998, JAMA.

[13]  U. Franklin.  The real world of technology , 1993 .

[14]  R. Broadhead,et al.  Drug Iatrogenesis and Clinical Pharmacy: The Mutual Fate of a Social Problem and a Professional Movement , 1985 .

[15]  S. Barley.  The New World Of Work , 1996 .

[16]  Andrew Webster,et al.  Rationalising Knowledge: IT Systems, Professional Identities and Power , 1998 .

[17]  C. Cockburn,et al.  Gender and technology in the making , 1993 .

[18]  R. Crompton,et al.  Paid Employment and the Changing System of Gender Relations: A Cross-National Comparison , 1996 .

[19]  M. Ivey.  SHIFTING PHARMACY'S PARADIGM , 1993 .

[20]  M. Ivey.  Harvey A. K. Whitney Lecture. Shifting pharmacy's paradigm. , 1993, American journal of hospital pharmacy.

[21]  Shoshana Zuboff.  In the Age of the Smart Machine , 1988 .

[22]  Rosalind Gill,et al.  The Gender-Technology Relation , 2018 .

[23]  Schnell Br.  A study of unit-dose drug distribution in four Canadian hospitals. , 1976 .

[24]  L C Vermeulen,et al.  Comparison of automated medication-management systems. , 1994, American journal of hospital pharmacy.

[25]  P. Rappaport,et al.  A study pre and post unit dose conversion in a pediatric hospital. , 1991, The Canadian journal of hospital pharmacy.

[26]  P. Adler.  New Technologies, New Skills , 1986 .

[27]  J. Lathrop,et al.  Restructuring Health Care: The Patient-Focused Paradigm , 1993 .

[28]  M. Larson.  The Rise of Professionalism: A Sociological Analysis , 1977 .

[29]  Kenneth N. Barker,et al.  The Problems of Detecting Medication Errors in Hospitals , 1962 .

[30]  W. Diebold,et al.  The Second Industrial Divide , 1985 .

[31]  V. Smith.  Institutionalizing Flexibility in a Service Firm , 1994 .

[32]  J. Law.  A Sociology of monsters: Essays on power, technology, and domination , 1991 .

[33]  C. Aydin.  Occupational adaptation to computerized medical information systems. , 1989, Journal of health and social behavior.

[34]  Stephen R. Barley,et al.  Between craft and science : technical work in U.S. settings , 1998 .

[35]  P. Attewell.  The Deskilling Controversy , 1987 .

[36]  Eli Ginzberg,et al.  Good Jobs, Bad Jobs, No Jobs , 1979 .

[37]  N. Jewson,et al.  'Reprofessionalization' or 'occupational imperialism'?: some reflections on pharmacy in Britain. , 1986, Social science & medicine.

[38]  J. Webster.  Shaping Women's Work: Gender, Employment and Information Technology , 1996 .

[39]  M. Mesler,et al.  Boundary encroachment and task delegation: clinical pharmacists on the medical team , 1991 .

[40]  Paul S. Adler.  Technology and the future of work , 1993 .

[41]  J. Wajcman.  Feminism Confronts Technology , 1991 .

[42]  Harley Shaiken,et al.  Work Transformed: Automation and Labor in the Computer Age , 1986 .

[43]  R. Ensom,et al.  Pharmacy technician refill checking: safe and practical. , 2018, The Canadian journal of hospital pharmacy.

[44]  B. Latour.  Science in Action , 1987 .

[45]  R. Westrum.  The Social Construction of Technological Systems , 1989 .

[46]  M. Callon.  Techno-economic Networks and Irreversibility , 1990 .

[47]  C E Hynniman,et al.  A comparison of medication errors under the University of Kentucky unit dose system and traditional drug distribution systems in four hospitals. , 1970, American journal of hospital pharmacy.

[48]  Stanley Aronowitz,et al.  [Book review] the jobless future, sci-tech and the dogma of work , 1994 .

[49]  K N Barker,et al.  Effect of an automated bedside dispensing machine on medication errors. , 1984, American journal of hospital pharmacy.

[50]  S. Shapin.  The Invisible Technician , 1989 .

[51]  A. Birenbaum,et al.  Reprofessionalization in pharmacy. , 1982, Social science & medicine.

[52]  Kay Sanderson,et al.  Gendered Jobs and Social Change , 1990 .

[53]  Judith A. Perrolle,et al.  Expert Enhancement and Replacement in Computerized Mental Labor , 1991 .

[54]  Steven P. Vallas,et al.  The Transformation of Work Revisited: The Limits of Flexibility in American Manufacturing , 1996 .

[55]  M. Reed,et al.  Expert Power and Control in Late Modernity: An Empirical Review and Theoretical Synthesis , 1996 .

[56]  Harold L. Wilensky,et al.  The Professionalization of Everyone? , 1964, American Journal of Sociology.