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From the start, it became apparent that the staff of the clinic encountered several
‘sensemaking challenges’: how many scanners were needed? Who should scan the
documents and when? Should there be changes to the workflow? What should be the
processes for handling, distribution, registration, and further processing of documents?
And why? Exceptions to initial assumptions surfaced as staff began to explore answers
to these questions. The process of making sense took place through tentative plans,
meetings, communication with the IT team and other hospitals services, mapping
workshops, discussion and negotiation, that progressively involved the entire hospital,
over a background of other concurrent change (e.g. the upgrade of the local area network
infrastructure).
Overall, ‘a seemingly trivial change (the installation of scanners) triggered a larger
organisational change process than what had initially been expected.’[16][p24].
Completion of the project took time, but in the end, based on the experiences of the pilot,
flexible procedures and organisational standards were developed, workflows were
changed, scanning was implemented across all departments and this eventually
completed the transition to paperless activities initiated with the initial EHR roll-out.
2.2. How the theory was applied to the case
Aanestad and Jensen took collective mindfulness to be an organisational capability
founded on processes of sensemaking. In seeking to understand the hospital
implementation of the EHR system, they therefore asked what sensemaking processes
occur during post-implementation adaptations and how these processes can be supported
for the organisation to achieve this capability. Having had the opportunity to learn about
the hospital decision of installing scanners to deal with paper records that remained in
use after EHR roll-out, they observed the unfolding of this IT project, participated in
meetings and interviewed the staff involved.
They mapped the ‘sensemaking challenges’ encountered in the hospital by the
people who were tasked with making sense of how to adapt their work practices around
‘the scanning’. Sensemaking activities were refined in terms of ‘making, giving,
demanding and breaking sense’ [p24] which were then ‘translated’ into the five
processes of collective mindfulness modified to be applicable to ‘an action-oriented
context’. For example, preoccupation with failure was translated into preoccupation with
constraints and preconditions. Deference to expertise, was manifested in the seeking out
of an appropriate mix of expertise (Table 3).
In this case study, the collective mindfulness lens reveals the collective cognitive
processes and associated activities necessary to bring the initiative to completion hospital
wide. The five dimensions are also proposed as an intervention towards future
‘successful’ implementations. This we discuss in the next section.
V.LichtnerandJ.I.Westbrook
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Buch Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Titel
- Applied Interdisciplinary Theory in Health Informatics
- Untertitel
- Knowledge Base for Practitioners
- Autoren
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Verlag
- IOS Press BV
- Ort
- Amsterdam
- Datum
- 2019
- Sprache
- englisch
- Lizenz
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Abmessungen
- 16.0 x 24.0 cm
- Seiten
- 242
- Kategorie
- Informatik