Hospital managers closely observed: Some features of new technology and everyday managerial work (original) (raw)

The NHS is experiencing enormous growth in the deployment of information and communications technologies (ICTs). Extensive use of technology serves to 'reconfigure the organisation' through its application in data analysis, communication and decision support This paper reports some preliminary findings from an ethnographic study of hospital information systems in everyday use, documenting precisely how people, systems and enterprises interact and collaborate. Our paper reports on some of the complexities involved in the use of ICTs in everyday managerial work and documents the articulation in practice of the cultural, organisational and technical arrangements through the investigation of the 'hands on' work of Hospital Trust management. Introduction: new technology and organisational life in the NHS. This paper presents some preliminary findings from our ongoing ethnomethodologically informed ethnographic studies (Hughes et al 1994) into managerial work and hospital information systems in everyday use. Our focus is the everyday work of various managers-Clinical Directors, Nurse Managers, Service Managers and Information Managers, and how people, systems and enterprises interact and collaborate. This involves shadowing various hospital managers-usually for a week at a time-documenting and tape-recording their everyday, practical activities moment-by-moment as they occurred (Clarke et al 2001). Our paper reports on some of the complexities involved in the use of Information and Communication Technologies (ICTs) in the provision of information, the production and utilisation of that information in everyday managerial work, and the variegated skill and trust factors relevant to information use in managerial working practices. It documents the articulation in practice of the cultural, organisational and technical arrangements for the use of ICTs in managerial working across organisational boundaries. This paper's interest in new technology and managerial work in the NHS is part of a more general concern with the 'future of work' and its relationship with technological change. This interest has developed against the background of major transformations in the social and economic environment. (Lash & Urry 1994) and the emergence of an 'Information Society' or 'Informational Economy' (Castells 1996) where a particular emphasis has been accorded the role of IT in supporting skill and knowledge and facilitating the coordination and control of work (Zuboff, 1988) as collaborative work becomes increasingly electronically supported (Grudin, 1990).

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