Sharing Workarounds in Health IT-Enabled Patient-Care Work: Impact on Clinicians

Abstract

Healthcare providers engaged in health information technology (HIT)-enabled patient-care work tend to resort to workarounds when problems arise in prescribed practices. Hospital administration discourages using such informal workarounds. Yet, due to the interdependent collaborative nature of hospital work, there is a tendency for clinicians to share informally with their colleagues the workarounds that they find useful. In this study, we investigate how the sharing of workarounds impacts the clinicians involved. Our qualitative field study within an inpatient hospital system allowed us to perform rich case studies on a set of four instantiations of the sharing of workarounds in electronic medication administration record (eMAR)-enabled medication administration work. Our findings offer the counterintuitive insight that positive outcomes can be realized from sharing workarounds, even when they are problematic. Our exploratory inductive research model presents a set of five propositions that explain two different ways in which the sharing of workarounds creates positive value for the clinicians involved. We encourage future research to investigate other consequences, and routes leading to those consequences, from the sharing of workarounds in various other IT-enabled contexts. Cumulatively, such research would inform, enrich, and even challenge traditional notions that largely prefer avoiding informal workarounds in the IT-enabled workplace.