Seamless information systems for critical care--myth or magic?
A multi-site study is described that evaluates the scope for seamless Clinical Information Systems (CIS) in critical care. Observations, shadowing of clinical staff, interviews and questionnaires show a triangulation in data collection methods as well as location triangulation as the study is conducted across four sites, two each in UK and Denmark. Role Activity Diagrams (RAD) are used to capture critical care work processes. The RADs are analysed to show the 'simplified complexity' of the work processes, which are changed by the introduction of information systems for the everyday use and management of all clinical information. Further, CIS that reconcile expectations of both hospital management and clinical staff and that have the potential to adapt to their organisational environment have a greater chance of surviving in autopoietic organisations such as critical care. Despite decades of Informatics, no such system exists in its entirety; this study shows that 'ancient problems' of clinical information systems development, implementation and integration are still heavily prevalent. However, the potential for CIS that consider integrating all clinical information requirements is immense.
Munir
Samina K
SK
SHIRE, The Faculty of Health and Social Care, The University of Salford, Greater Manchester, UK. samina.munir@hotmail.com
Kay
Stephen
S
D003422:Critical Care; D006751:Hospital Information Systems; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D018511:Systems Integration; D013647:Task Performance and Analysis; D000078329:Workforce; D016526:Workload