• Hanne Schmidt Bjerrum
  • Simone Behr
3 year, Master of Health Informatics (Continuing education) (Continuing Education Programme (Master))
Background: The increasing difficulty of attracting manpower, combined with an increasing tendency for workers to “job-shop” or for freelance working via private employment agencies has the effect of increasing staff turnover in the public Health Service. This tendency is a challenge for individual employers, who find it increasingly difficult to retain the necessary experience and skills in the workplace, as well as reducing the opportunities for passing on these skills to less experienced colleagues. At the same time health care workers are faced with a demand for continual improvements in quality and the increased documentation this requires. It is therefore relevant to investigate whether the sharing of knowledge and passing-on of skills can be facilitated by health informatics, and how this will affect the involved workers. Purpose: This investigation has focussed on the experiences of the staff at a local psychiatric practice re-garding the availability of electronically stored guidelines accessible via a large touch-screen; how this affects their work practices, training of new staff, cooperation between colleagues, interruptions and the quality of care and treatment. Method: A preliminary study was undertaken of the psychiatric services of Region Syddanmark, Vejle, in order to acquire knowledge of the area and to enable preparation for data collection. The pre-liminary study consisted of the following: document analysis, observation, telephone interviews and the implementation group’s expectations of the project. Based on the preliminary study, ten qualitative interviews with subjects from the two psychiatric wards in Vejle were carried out. The interviews were transcribed verbatim and thereafter meaning-condensed. The condensed data were analysed from a socio-technical perspective using two methods from two different fields: an Interactive Socio-technical Analysis (ISTA) (health informatics angle) and using the Actor-Network Theory (ANT) (sociological angle). Result: Both expected and unexpected effects of the technology on clinical practice have been identified, and these have been mainly positive. We suggest that the ISTA model could be improved by the addition of two dimensions - the context of the surroundings, and the interaction between the social system and the technical and physical infrastructure. The ISTA model’s structure is both an advantage and restrictive when analysing the data. The ANT model gives a wider perspective which has enabled a more subtle analysis, but at the same time is difficult to use. Conclusion: The availability of electronically stored guidelines accessible via a large touch-screen can facilitate the introduction and teaching of new staff, improve cooperation within the team and the quality of care and treatment of patients. The problem of interruption was not assessed in depth, but the technology does not appear to prevent interruption in psychiatric practice. The Danish Quality Model and accreditation are identified as a problem area in relation to clinical values.
Publication date2009
Number of pages148
Publishing institutionAalborg Universitet
ID: 17582287