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Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team

Author

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  • Bergey, Meredith R.
  • Goldsack, Jennifer C.
  • Robinson, Edmondo J.

Abstract

Hospitals have invested heavily in health information technology (HIT) which has been promoted as an integral component of quality, safe, and efficient health-care delivery. Research on the expanding use of such technology, however, has shown that user/technology interactions are shaped through practices of use that can yield far from normative, even unexpected outcomes. Drawing upon focus group and interview data from an inpatient, two-hospital health system in the United States, this paper considers the perceived impact of HIT implementation on work practices and roles for nurse managers and unit clerks. We find that HIT implementation generated significant reconfigurations of work practices at the expense of nurse/patient interaction. Following such changes, nursing leadership described re-prioritizing patient care and interaction - perceived to them as essential to the patient experience and unit functioning - through realignments in staffing that prioritized more versatile staff and task delegation of largely invisible, articulation work to unit clerks. Despite maintaining an integral role as “gatekeeper” and the “face on the floor,” unit clerks experienced significant reconfigurations of their work and some concomitant uncertainty about their role. We consider the implications of our findings for literature on the socio-materiality of HIT, with particular attention to literature on work practices, roles, and the visibility of work within organizational power hierarchies.

Suggested Citation

  • Bergey, Meredith R. & Goldsack, Jennifer C. & Robinson, Edmondo J., 2019. "Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
  • Handle: RePEc:eee:socmed:v:235:y:2019:i:c:27
    DOI: 10.1016/j.socscimed.2019.112387
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    Citations

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    Cited by:

    1. Bernice Redley & Tracy Douglas & Mari Botti, 2020. "Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(9-10), pages 1477-1487, May.
    2. Diego Tlapa & Guilherme Tortorella & Flavio Fogliatto & Maneesh Kumar & Alejandro Mac Cawley & Roberto Vassolo & Luis Enberg & Yolanda Baez-Lopez, 2022. "Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review," IJERPH, MDPI, vol. 19(15), pages 1-23, July.
    3. Francesca Bonetti & Matteo Montecchi & Kirk Plangger & Hope Jensen Schau, 2023. "Practice co-evolution: Collaboratively embedding artificial intelligence in retail practices," Journal of the Academy of Marketing Science, Springer, vol. 51(4), pages 867-888, July.
    4. Tortorella, Guilherme Luz & Fogliatto, Flavio S. & Kurnia, Sherah & Thürer, Matthias & Capurro, Daniel, 2022. "Healthcare 4.0 digital applications: An empirical study on measures, bundles and patient-centered performance," Technological Forecasting and Social Change, Elsevier, vol. 181(C).

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