Formalizing work: reallocating redundancy

This paper reports from an introduction of the electronic patient record for nurses in a Norwegian hospital. In addition to establish electronic written accounts of nurses' reports, a major aim was to formalize nurses' work, related to handover conferences. Despite the projects proclaimed success, like reduced overtime, improved quality of the written documentation and eliminated redundancy, our analysis demonstrates an opposite effect. Formalizing the nursing handover and thus reduce redundancy, in fact resulted in a reintroduction of redundancy, although at another time and place. We found that work (and redundancy) in fact had moved, to another time (i), into different artifacts (ii), or old artifacts that now were used/annotated differently (iii).

[1]  Claus Bossen,et al.  The parameters of common information spaces:: the heterogeneity of cooperative work at a hospital ward , 2002, CSCW '02.

[2]  Wilhelm Hasselbring,et al.  The SI challenge in health care , 2000, CACM.

[3]  M. Berg,et al.  Waiting for Godot: Episodes from the History of Patient Records , 2004 .

[4]  Ting-Ting Lee,et al.  Nurses' concerns about using information systems: analysis of comments on a computerized nursing care plan system in Taiwan. , 2005, Journal of clinical nursing.

[5]  Signe Vikkelsø,et al.  Subtle Redistribution of Work, Attention and Risks: Electronic Patient Records and Organisational Consequences , 2005, Scand. J. Inf. Syst..

[6]  C. Ruland,et al.  Developing a module for nursing documentation integrated in the electronic patient record. , 2001, Journal of clinical nursing.

[7]  J. Law,et al.  Ladbroke Grove, or How to Think about Failing Systems , 2000 .

[8]  Christian Heath,et al.  Documents and professional practice: “bad” organisational reasons for “good” clinical records , 1996, CSCW '96.

[9]  Marc Berg,et al.  Orders and Their Others: On the Constitution of Universalities in Medical Work , 2000 .

[10]  A. Young Sorting Things Out: Classification and Its Consequences. , 2001 .

[11]  Wanda J. Orlikowski,et al.  Research Commentary: Desperately Seeking the "IT" in IT Research - A Call to Theorizing the IT Artifact , 2001, Inf. Syst. Res..

[12]  D. Bomba,et al.  A description of handover processes in an Australian public hospital. , 2005, Australian health review : a publication of the Australian Hospital Association.

[13]  P. Agre Lucy A. Suchman, Plans and Situated Actions: The Problem of Human-Machine Commuinication (Cambridge University Press, Cambridge 1987) , 1990, Artif. Intell..

[14]  J. Lachmund,et al.  Making Sense of Sound: Auscultation and Lung Sound Codification in Nineteenth-Century French and German Medicine , 1999 .

[15]  M. Kerr A qualitative study of shift handover practice and function from a socio-technical perspective. , 2002, Journal of advanced nursing.

[16]  Paul Atkinson,et al.  Medical talk and medical work , 1995 .

[17]  E. Hutchins Cognition in the wild , 1995 .

[18]  Gunnar Ellingsen,et al.  A Patchwork Planet Integration and Cooperation in Hospitals , 2003, Computer Supported Cooperative Work (CSCW).

[19]  Brit Ross Winthereik,et al.  ICT and Integrated Care: Some Dilemmas of Standardising Inter-Organisational Communication , 2005, Computer Supported Cooperative Work (CSCW).

[20]  Rob Kling,et al.  Cooperation, coordination and control in computer-supported work , 1991, CACM.

[21]  J. Orr,et al.  Talking About Machines: An Ethnography of a Modern Job. , 1997 .

[22]  Rob Procter,et al.  Making a Case in Medical Work: Implications for the Electronic Medical Record , 2003, Computer Supported Cooperative Work (CSCW).

[23]  P Coleman,et al.  'Scraps': hidden nursing information and its influence on the delivery of care. , 2000, Journal of advanced nursing.

[24]  J. Lave,et al.  Understanding Practice: Perspectives on Activity and Context , 1996 .

[25]  Lucy Suchman Plans and situated actions: the problem of human-machine communication , 1987 .

[26]  Seth Chaiklin,et al.  Understanding practice: Understanding the social scientific practice of Understanding practice , 1993 .

[27]  Geoff Walsham,et al.  Interpretive case studies in IS research: nature and method , 1995 .

[28]  Marc Berg,et al.  Accumulating and Coordinating: Occasions for Information Technologies in Medical Work , 1999, Computer Supported Cooperative Work (CSCW).

[29]  E. Manias,et al.  The handover: uncovering the hidden practices of nurses. , 2000, Intensive & critical care nursing.

[30]  Connie V. Chan,et al.  Nursing handovers: do we really need them? , 2004, Journal of nursing management.

[31]  D. Wellman,et al.  Talking About Machines: An Ethnography of a Modern Job. , 1997 .

[32]  Hemant K Kassean,et al.  Bmc Nursing Managing Change in the Nursing Handover from Traditional to Bedside Handover – a Case Study from Mauritius , 2022 .

[33]  Michael D. Myers,et al.  A Set of Principles for Conducting and Evaluating Interpretive Field Studies in Information Systems , 1999, MIS Q..

[34]  Aksel Tjora,et al.  Maintaining redundancy in the coordination of medical emergencies , 2004, CSCW.

[35]  L. Baldwin,et al.  A computer-generated shift report. , 1994, Nursing management.

[36]  M. Getty,et al.  A comparative study of the attitudes of users and non-users towards computerized care planning. , 1999, Journal of clinical nursing.

[37]  Christian Heath,et al.  Technology in Action: Documents and professional practice: ‘bad’ organisational reasons for ‘good’ clinical records , 2000 .

[38]  Davina Allen,et al.  Re-reading nursing and re-writing practice: towards an empirically based reformulation of the nursing mandate. , 2004, Nursing inquiry.

[39]  Christian Heath,et al.  Collaboration and controlCrisis management and multimedia technology in London Underground Line Control Rooms , 1992, Computer Supported Cooperative Work (CSCW).

[40]  Jonathan Grudin,et al.  Groupware and social dynamics: eight challenges for developers , 1994, CACM.

[41]  Eric Monteiro,et al.  Inscribing behaviour in information infrastructure standards , 1997 .

[42]  L. Hong,et al.  Modulated Participant-Observation: Managing the Dilemma of Distance in Field Research , 2002 .

[43]  Carla Simone,et al.  When once is not enough: the role of redundancy in a hospital ward setting , 2005, GROUP.