Int J Med Inform - Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow.

Tópicos

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{ patient(2315) diseas(1263) diabet(1191) }
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Resumo

JECTIVE: The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training.METHODS: We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives.RESULTS: Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use.DISCUSSION: Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff.

Resumo Limpo

jectiv purpos paper demonstr current visual represent organiz technolog process fulli account variabl present everyday practic demonstr narrat network can augment represent indic potenti area success problemat adopt new technolog potenti need addit trainingmethod conduct qualit studi process routin major academ medic center slate support develop instal new comprehens hit system use qualit data collect techniqu includ observ activ support new system interview depart head research clinic nonclin staff conduct narrat network analysi data choos exemplar process model select analyz narrat fragment develop visual represent interconnect narrativesresult narrat network enabl us view varieti way work can perform practic influenc abil design innov usediscuss narrat network mean analyz visual organiz routin concert tradit requir engin workflow model qualiti improv outcom measur type analysi can support deeper nuanc understand certain routin continu exist chang stop entir time can illumin area adopt may slow train communic may need routin prefer leadership subvert routin prefer staff

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