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PURPOSE When barcode medication administration (BCMA) is implemented nurses are required to integrate not only a new set of procedures or artifacts into everyday work, but also an orientation to medication safety itself that is sometimes at odds with their own. This paper describes how the nurses' orientation (the Practice Frame) can collide with the(More)
As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the(More)
The objective of this review was to describe methods used to study and model workflow. The authors included studies set in a variety of industries using qualitative, quantitative and mixed methods. Of the 6221 matching abstracts, 127 articles were included in the final corpus. The authors collected data from each article on researcher perspective, study(More)
Designing patient-centered consumer health informatics (CHI) applications requires understanding and creating alignment with patients' and their family members' health-related activities, referred to here as 'patient work'. A patient work approach to CHI draws on medical social science and human factors engineering models and simultaneously attends to(More)
Public interest in the quality and safety of health care has spurred examination of specific organizational routines believed to yield risk in health care work. Medication administration routines, in particular, have been the subject of numerous improvement projects involving information technology development, and other forms of research and regulation.(More)
OBJECTIVE Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. (More)
A case study was conducted during the customization phase of a commercial CPOE system at a multi-hospital, academic health system. The study focused on the development of order sets. Three distinct approaches to order set development were observed: Empirical, Local Consensus and Departmental. The three approaches are first described and then examined using(More)
This paper introduces a new internal combustion engine having three rotary parts only. The first section presents the structure of the innovative new construction based on the patented version. The main parts detail the construction questions that came up at the design phase, then analyse the manufacturability and give the steps of the elaborated technology(More)