Page - 101 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

or team) can be said to be mindful, or have a mindfulness capability, the same way that it is said that organisations learn or have learning capabilities [9]. In contrast to other studies of cognition in organisations, understanding activities and organisations in terms of sensemaking and collective mindfulness takes us away from the traditional decision-making lens. Traditionally decision making is explained as a rational selection between options. Although seen as the combination of two processes of judgement and choice, decision making is typically studied from an individual (cognitive) perspective. The focus is often placed on the outcome (the judgment, the decision). Instead, understanding sensemaking requires a dynamic perspective and a focus on the (social) activity in context. 1.2. Making sense and ‘the unexpected’ Sensemaking in organisations is about making sense of unusual events, ambiguous information, or unexplained variations of performance. Organisations are complex sociotechnical environments – they are open adaptive systems. Take for example the implementation of a large clinical information system being rolled-out across multiple hospitals. In such environments it is inevitable that new events and situations will appear that could not have been anticipated, or were known to some but not made known to the designers/implementers (also referred to as ‘unknown knowns’ [10]). These situations create uncertainty and therefore require ‘making sense of’. This is what is usually referred to as ‘the unexpected’ [8], although the expression may also be used more generally to refer to any unwanted outcomes or issues (errors, accidents) in organisational processes. Examples of the unexpected in an IT implementation project may include agreed requirements that become contested, unanticipated changes in workflows, or use of an IT system to complete work in ways which had not been foreseen. The case below illustrates making sense of, and resolving the unexpected in an IT initiative requiring the involvement of stakeholders, and processes of discovery and negotiation – overall, a process of collective sensemaking. In the organisational literature, depending on the perspective taken to understand the making of sense in organisations, attention has been paid to activities of sense-giving (attempts to influence others’ interpretations), sense-breaking (when sense is ‘breaking down’), or sense-exchanging (social negotiation), among others. We will return to some of these in the case discussed below. 1.3. Methods used to research phenomena within this theoretical frame Weick and Roberts explain that the word ‘collective’ “refers to individuals who act as if they are a group”. This means they “interrelate their actions” (and they do so “with more or less care”) [4][p360]. Since its beginning, empirical research on collective mindfulness has therefore attempted to capture these processes of interrelating, achieving this with in-depth ethnographic case studies (e.g. [4]). This method is the most suitable for capturing the dynamics of activities in context. In these studies, the unit of analysis often shifts between individuals and groups [3], ‘since only individuals can contribute to a collective mind, but a collective mind is distinct from an individual mind because it inheres in the pattern of interrelated activities among many people’ [4][p360]. Qualitative studies of this kind have made useful contributions to the original theory by investigating these phenomena in very different organisational contexts. For example V.LichtnerandJ.I.Westbrook /CollectiveMindfulnessandProcessesofSensemaking 101