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Investigates theoretically and empirically what it means to design technological artefacts while embracing the large number of practices which practitioners engage with when handling technologies. The authors discusses the fields of design and sociomateriality through their shared interests towards the basic nature of work, collaboration, organization, technology, and human agency, striving to make the debates and concepts originating in each field accessible to each other, and thus moving sociomateriality closer to the practical concerns of design and providing a useful analytical toolbox to information system designers and field researchers alike.

Sociomaterial-Design: Bounding Technologies in Practice takes on the challenge of redefining design practices through insights from the emerging debate on sociomateriality. It does so by bringing forward a comparative examination of two longitudinal ethnographic studies of the practices within two emergency departments – one in Canada and one in the United States of America. A particular focus is placed upon the use of current collaborative artefacts within the emergency departments and the transformation into digital artefacts through design.

Inhaltsverzeichnis

Frontmatter

1. Introduction

Abstract
A sociomaterial-designer walks into an emergency department (ED). It is a very busy environment where nurses, doctors, paramedics, patients, clerks, cleaners, and others are moving around exchanging documents, clipboards, test results, and fluid samples while annotating coordinative artefacts such as whiteboards or paper forms. At first, when the sociomaterial-designer arrives, she feels overwhelmed by what she sees. The sociomaterial practices appear complex, dynamic, and highly entangled, and individual activities—such as the arrival of a patient who requires immediate resuscitation—send ripples through the whole ED. Such activities involve not only the healthcare practitioners attending to the new patient, but also the dynamic state of the sociomaterial practices that make up the ED.
Pernille Bjørn, Carsten Østerlund

Theoretical perspective

Frontmatter

2. Sociomateriality & Design

Abstract
The aim of this book is to create a theoretical foundation for how we can combine the insights from sociomateriality with the interests of design and vice versa. This mean that we need to start to unpack both sociomateriality and design to study their foundations and then identify a common ground to create the new entity of Sociomaterial-Design. In this chapter we will introduce sociomateriality and design, while identifying the common ground between these—namely the practice-based interest.
Pernille Bjørn, Carsten Østerlund

Empirical perspective

Frontmatter

3. Ethnographic Studies of work in Emergency Departments

Abstract
The empirical foundation of this book is made up of two longitudinal studies of the work practices and technology design changes in two EDs in North America. In this chapter, we will introduce the empirical cases and the contexts for each of the studies. We decided to introduce the cases as narratives from each of our own personal perspectives as researchers. This will provide the reader insights into how the studies came about and how the sociomaterial-design approach was enacted in practice.
Pernille Bjørn, Carsten Østerlund

4. Analytical Approach to Study Sociomaterial Nature of Artefacts

Abstract
For the purpose of this book, we wanted to compare the empirical data from our two extensive ethnographic field studies of two pediatric EDs. While in the previous chapter, we presented two narratives of the research engagements with the different field sites, we will now explain in more detail how we methodologically approach the two sites. In addition, and maybe even more importantly, we show how, in the analytical process, we engaged with an enormous amount of rich, in-depth qualitative empirical data from the two sites.
Pernille Bjørn, Carsten Østerlund

5. Bounding Practices

Abstract
In this chapter, we present the results of our analytical process, untangling the dynamic boundaries for the key artefacts that organize the work in the Canadian and U.S. EDs. The process strives to illuminate the sociomaterial nature of the artefacts by affirming that those artefacts are always part of larger and smaller entanglements. Each of these entanglements constitutes a sociomaterial artefact in its own right—part of the bounding practices providing a distinct order to the ED world and allowing doctors and nurses to perform different sociomaterial practices. In short, the artefacts we untangle are not pre-given but bound up in multiple orderings.
Pernille Bjørn, Carsten Østerlund

6. Transforming the Sociomateriality of the Triage Template: Canadian ED

Abstract
In the Canadian ED, one essential artefact is the triage template. The triage template is used during the triage interview during which the triage nurse assesses the urgency of the patient’s condition while documenting indicators such as airway, breathing, circulation, weight, temperature, etc. As part of the larger EDIS project, the paper-based triage template was replaced with a digital triage template. The paper-based triage template came in three different versions: one for psychiatric patients, one for acute patients, and one for fast-track patients. Each version has a number of fields to be filled out and on the back of the triage template the fields for documenting the nursing notes are pre-printed. In practice, this means that the paper-based triage template is used on the one side to document the triage assessment and on the other side to document the nursing intervention throughout the patient’s stay in the ED.
Pernille Bjørn, Carsten Østerlund

7. Negotiating Boundings: New Order Flags in U.S. ED

Abstract
The dynamic bounding of artefacts, locations, and people’s mobility doesn’t merely surface when introducing large systems such as the EDIS in the Canadian ED. As a coordinative artefact changes or a new artefact gets introduced, the alteration inevitably leads to deliberations and often conflicts about what intra-actions best support particular agential cuts. Such negotiations monopolize most departmental staff meetings, whether in the ED, inpatient wards, or the primary care clinics. At first glance, such meetings appear to be an unorganized as workplace meetings. This is in fact, is how many ED staff members feel about the meetings and is why they do not bother to show up. Nevertheless, the jagged course of such debates points to the importance staff members ascribe to the bounding practices they perform on a daily basis. To ensure coordination among doctors, nurses, and secretaries, these groups continuously tweak their work along with the bounding of artefacts, locations, and people’s movements. These changes lead to conflicts, as they bring to light the stark contrasts between the very performances that constitute doctors’ and nurses’ work and the power positions in the ED.
Pernille Bjørn, Carsten Østerlund

Sociomaterial-Design

Frontmatter

8. Boundaries and Intra-Actions

Abstract
At first glance, any attempt to articulate a sociomaterial-design approach seems insurmountable, an oxymoron. Despite their shared commitment to a practice-based approach and the importance of materiality, they appear to turn their noses in opposite directions. One privileges the artefact while the other rejects any distinction between the human and the material. One does not question the boundaries associated with an artefact; the other insists no boundary is set in stone. One tends to look for inter-actions between the social and the technical; the other swears to intra-actions. Is it impossible to bring Ada and Alan together?
Pernille Bjørn, Carsten Østerlund

9. Sociomaterial-Design Beyond Healthcare

Abstract
In this book, the domain of interest has been healthcare practice and, in particular, the work practices within EDs in North America. However healthcare practice is a particular type of practice, creating particular conditions for conducting sociomaterial-design. One of the basic conditions is that when you, as a sociomaterial-designer, enter the healthcare practice within a hospital, you encounter people, practices, and artefacts that all move around—making it possible for you to tag along. The actual practice of healthcare practitioners is very visible since interaction with a patient is a physical activity and the traditional coordination and organization of the work includes observable practices using tools such as clipboards, chart-racks, and whiteboards. Sociomaterial-design is not a restricted approach to only study healthcare; it is a general approach to the study of work practices with the aim of designing technology. However, sociomaterial-design will take different forms when executed within other domains. It is not within the scope of this book to completely unfold the meaning of sociomaterial-design in all different kinds of domains. However, it is in the scope of this book to consider and propose the questions that need to be addressed when conducting sociomaterial-design in settings other than healthcare practices. Thus, the questions we address in this chapter is how the conditions for conducting sociomaterial-design change or are transformed when introduced into domains different from healthcare, and what questions should the sociomaterial designer address when initiating such new investigations.
Pernille Bjørn, Carsten Østerlund

10. Implications of Sociomaterial-Design

Abstract
The sociomaterial-design agenda has implications for researchers and practitioners who are designing new coordinative artefacts for specific contexts, for example, when replacing paper-based systems with digital artefacts in a hospital setting, or collaborative systems for global work. We can no longer regard any of these artefacts as being pre-determined and stable. Instead, their boundaries are dynamic and created by the practitioners at different points in time, for particular purposes, through the bounding practices. People bound technologies in practice, and we should design with this in mind. Multiple boundings co-exist, each created by various practitioners for particular purposes. It is up to the sociomaterial-designer to identify relevant boundings by experimenting with and challenging the obvious boundaries that tend to appear to figure out whether other extremely relevant ways to bundle doings, materialities, and discourses co-exist and should be taken into account within new designs.
Pernille Bjørn, Carsten Østerlund
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