Adapting structuration theory to understand the role of reflexivity: Problematization, clinical audit and information systems

This paper is an exploratory account of the further development and application of a hybrid framework, StructurANTion, that is based on Structuration Theory and Actor Network Theory (ANT). The use of social theories in general and their use in information systems (IS) research in particular is explored leading to the use of the framework to examine the concept of what are termed humanchine networks in the context of clinical audit, within a healthcare Primary Care Trust (PCT). A particular focus is on the manner in which information systems-based reflexivity contributes to both entrenching a networks’ structurated order as well as contributing to its emancipatory change. The case study compares clinic-centric and patientcentric audit and seeks to further extend the understanding of the role of information and information systems within structurated humanchine activity systems. Conclusions indicate that the use of more socially informed IS methods and approaches can incorporate more emancipatory ideals and lead to greater adoption and usage of more relevant and useful clinical information systems and practices

Managing Triads in a Military Avionics Service Maintenance Network in Taiwan

Purpose – The purpose of this paper is to investigate how different types of triad structures, and the management mechanisms adopted by the focal company, affect cooperative performance. Design/methodology/approach – This paper uses a social network perspective to examine the triad management phenomenon in the military avionics maintenance context, which is closely associated with the field of operations management. Findings – This paper demonstrates that different triad structures and management mechanisms influence perceived cooperative performance. Four main findings emerged: in a triad, a firm playing a bridging role perceives higher cooperative performance than when playing a peripheral role in the triad or being located in a fully connected triad. When a firm plays the bridging role in a triad, and has a high level of trust, this leads to higher perceived cooperative performance. When a firm plays a peripheral role in a triad, high levels of coordination mechanism combined with high levels of trust result in higher levels of perceived cooperative performance. In a fully linked triad, when the coordination mechanism is well developed, the level of trust is high, so that the resulting level of perceived cooperation is high. Originality/value – This paper extends the knowledge of triad management by providing an in-depth study of a well-defined network setting with exceptionally high-level access to the most senior executives. In practice, this paper shows how to manage differen

Reconfiguring Household Management in Times of Discontinuity as an Open System: The Case of Agro-food Chains

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This article is based upon a heterodox approach to economics that rejects the oversimplification made by closed economic models and the mainstream concept of ‘externality.’ This approach re-imagines economics as a holistic evaluation of resources versus human needs, which requires judgement based on understanding of the complexity generated by the dynamic relations between different systems. One re-imagining of the economic model is as a holistic and systemic evaluation of agri-food systems’ sustainability that was performed through the multi-dimensional Governance Assessment Matrix Exercise (GAME). This is based on the five capitals model of sustainability, and the translation of qualitative evaluations into quantitative scores. This is based on the triangulation of big data from a variety of sources. To represent quantitative interactions, this article proposes a provisional translation of GAME’s qualitative evaluation into a quantitative form through the identification of measurement units that can reflect the different capital dimensions. For instance, a post-normal, ecological accounting method, Emergy is proposed to evaluate the natural capital. The revised GAME re-imagines economics not as the ‘dismal science,’ but as one that has potential leverage for positive, adaptive and sustainable ecosystemic analyses and global ‘household’ management. This article proposes an explicit recognition of economics nested within the social spheres of human and social capital which are in turn nested within the ecological capital upon which all life rests and is truly the bottom line. In this article, the authors make reference to an on-line retailer of local food and drink to illustrate the methods for evaluation of the five capitals model

Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method

Background: The extensive and rapidly expanding research literature on electronic patient records (EPRs) presents challenges to systematic reviewers. This literature is heterogeneous and at times conflicting, not least because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Aim: To map, interpret and critique the range of concepts, theories, methods and empirical findings on EPRs, with a particular emphasis on the implementation and use of EPR systems. Method: Using the meta-narrative method of systematic review, and applying search strategies that took us beyond the Medline-indexed literature, we identified over 500 full-text sources. We used ‘conflicting’ findings to address higher-order questions about how the EPR and its implementation were differently conceptualised and studied by different communities of researchers. Main findings: Our final synthesis included 24 previous systematic reviews and 94 additional primary studies, most of the latter from outside the biomedical literature. A number of tensions were evident, particularly in relation to: [1] the EPR (‘container’ or ‘itinerary’); [2] the EPR user (‘information-processer’ or ‘member of socio-technical network’); [3] organizational context (‘the setting within which the EPR is implemented’ or ‘the EPR-in-use’); [4] clinical work (‘decision-making’ or ‘situated practice’); [5] the process of change (‘the logic of determinism’ or ‘the logic of opposition’); [6] implementation success (‘objectively defined’ or ‘socially negotiated’); and [7] complexity and scale (‘the bigger the better’ or ‘small is beautiful’). Findings suggest that integration of EPRs will always require human work to re-contextualize knowledge for different uses; that whilst secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper, far from being technologically obsolete, currently offers greater ecological flexibility than most forms of electronic record; and that smaller systems may sometimes be more efficient and effective than larger ones. Conclusions: The tensions and paradoxes revealed in this study extend and challenge previous reviews and suggest that the evidence base for some EPR programs is more limited than is often assumed. We offer this paper as a preliminary contribution to a much-needed debate on this evidence and its implications, and suggest avenues for new research