From plans to planning

Abstract

Drawing on a critical perspective stemming from socially informed studies of medicine, we analyze an ongoing effort to establish electronic nursing plans at the university hospital of central Norway (St. Olav's hospital). We argue for an alternative interpretation of the relative lack of success to date of making the nurses use the nursing plans. Rather than a preoccupation with the singular artifact -the plan -we emphasize the process of planning as a collective, ongoing and heterogeneous achievement. Our perspective on plans implies that they should be recognized as more of a network and less a singular artifact.

"It is Not Because You Have Tools that You Must use Them"

“…The failure to position the suitcase and the Esperanto as a support for improving cooperation between the EMDC and nursing homes is consistent with existing cooperative work analyses on a "could have been" boundary object [22,26]. As Star reminds us [39], boundary objects should be thought of both in their material dimension, the artifact, and their process dimension, the practices associated with their production and use.…”

“…Overlooking the networked and continuous adaptation activity of the nurses to organize the care plan was also presented as an explanation for the failure of a project aimed at deploying a computer-based system in a University Hospital [26].…”

“…In other words, a negotiation on how (practically) the suitcase could be used to ensure better cooperation between the EMDC and nursing homes did not occur and was missing. We join Munkvold, Ellingsen, and Monteiro [26] in their analysis that work practices, such as planning or defining an emergency situation in our case, have to be addressed before even specifying the artifact that would allow for better cooperation. This learning appears to us as still neglected in many projects aimed at supporting an evolution of inter-organizational cooperation, or at least cooperation.…”