Workarounds : The Path From Detection to Improvement

Abstract

Health Information Systems are built to support work processes in healthcare organisations. In advance, it is difficult to plan how those processes will run in practice. Nurses, doctors, and other healthcare professionals, run into obstacles when using these systems in their daily work. In an attempt to circumvent these obstacles, they use so-called workarounds: intentional deviations from the prescribed work process. These workarounds are common in healthcare organisations and can have both beneficial and detrimental effects on healthcare processes. This PhD thesis sets out from the conviction that workarounds – beneficial or not – can serve to indicate misalignments between information systems and the work processes they are supposed to support. Using a wide range of methods and techniques, we offer a number of solutions for detecting and analysing workarounds in healthcare organisations, all with the aim of improving work processes in healthcare. We contribute to the scientific literature and healthcare practice in the form of (1) providing insights into the factors that are important in the emergence of workarounds, (2) offering insights into the correct way of addressing different types of workarounds, (3) providing methodological support for detecting and analysing workarounds, and (4) providing methodological support for translating knowledge about workarounds into actionable ideas for process improvements.