THE ROLE OF WORKAROUNDS DURING AN OPENSOURCE ELECTRONIC MEDICAL RECORD SYSTEM IMPLEMENTATION

A significant degree of customization of medical information technology is required to effectively integrate the promise of IT with the diversity and complexity of medical work. In the absence of such customizations, dissatisfaction and resistance toward the system arise. Indeed, the complexity of the medical work and the inability of software to tailor to the diverse medical practices may explain the limited diffusion of health information systems especially in North America. We study the role of workarounds during an open-source Electronic Medical Record System (EMR) implementation at a medium-size urgent care clinic in a major Canadian city. We found that the technology appropriation process involved the evolving of number of non-trivial workarounds in order to match the EMR to medical work. The emergence of workarounds is conceptualized as a knowledge creation and integration process. This perspective allows us to look at the antecedents and the change dynamics of workarounds in the clinic. Furthermore diverging from the negative view toward workarounds, we discuss the importance of incorporating workarounds during and following system development. The workaround perspective shed the light on how users’ behavior can be channeled into a constructive development effort. This paper contributes by examining the workaround of medical practitioners using an open-source electronic medical record system as well as offering a knowledge perspective for the study of EMR appropriation

Social media use in HR management; rule making, rule breaking and workarounds: a sociomaterial view

Employees use alternative tools and technologies to modify existing routines such that shortcomings in organisational processes can be overcome by deviating from prescribed procedures. These practices are referred to as “workarounds” and present a recognised yet under-researched phenomenon. Our study investigates how employees use social media as tools for compensating for shortcomings of existing information technologies and the effects of these workarounds on the strength of the HR communication process. We present a multiple case study to demonstrate workarounds in large UK organisations and to describes the intended outcomes and undesired side-effects. We further suggest an extension to the established structurational model of technology to incorporate effects of workarounds and conclude with an outlook for further research. The findings further offer practical application in the HR field by demonstrating how social media can be adopted into the existing HR processes

Theory of Workarounds

Although mentioned frequently in the organization, management, public administration, and technology literatures, workarounds are understudied and undertheorized. This article provides an integrated theory of workarounds that describes how and why workarounds are created. The theory covers most types of workarounds and most situations in which workarounds occur in operational systems. This theory is based on a broad but useful definition of workaround that clarifies the preconditions for the occurrence of a workaround. The literature review is organized around a diagram that combines the five “voices” in the literature of workarounds. That diagram is modeled after the diagram summarizing Orton and Weick’s [1990] loose coupling theory, which identified and combined five similar voices in the literature about loose coupling. Building on that basis, the theory of workarounds is a process theory driven by the interaction of key factors that determine whether possible workarounds are considered and how they are executed. This theory is useful for classifying workarounds and analyzing how they occur, for understanding compliance and noncompliance to methods and management mandates, for incorporating consideration of possible workarounds into systems analysis and design, and for studying how workarounds and other adaptations sometimes lead to larger planned changes in systems

Prevent, Redesign, Adopt or Ignore: Improving Healthcare Using Knowledge of Workarounds

The complex and variable nature of healthcare work makes alignment of health information systems to healthcare processes a challenge, causing the emergence of workarounds. We developed three artifacts to use knowledge of workarounds to address this misalignment and enable the improvement of work systems. (1) The Workaround Snapshot, in which the necessary social and technical information about a workaround is captured, such as motivation, impact on the work system, and possible actions that can be taken. (2) The Workaround Action Impact Matrix, which illustrates the possible decisions that can be made. (3) The Workaround Snapshot Approach, a socio-technical approach that uses the previous artifacts to enable continuous improvement. Following the principles of design science, the artifacts are demonstrated and evaluated through a case study at a Dutch hospital, where we identified and examined twelve workarounds. The approach has proven to enable the organization to make well-informed decisions on actions to be taken, which at times result in direct improvement of the work system. We contribute to existing research in moving past the identification and categorization of workarounds, towards utilizing explicit knowledge of workarounds to improve the work system

Costing study of two-year accelerated honours degrees

Report to HEFCE by Liz Hart Associates. "[This] study had two key objectives: to provide evidence of the impact of two-year accelerated honours degrees on course costs; to make comparisons with the costs of comparable degrees delivered through the traditional three-year route; and, in addition, the study was to consider any barriers to the possibility of expansion of two-year accelerated honours degrees... The indicative cost comparisons and institutional modelling in this study clearly show the potential for cost savings represented by two-year accelerated honours degrees. However, the realisation of these savings presents further challenges for institutions and the study makes recommendations to HEFCE as to how some of these might be addressed." - pp 3-4

A Workaround Design System for Anticipating, Designing, and/or Preventing Workarounds

Idealized system design produces requirements reflecting management intentions and “best practices.” This paper proposes a workaround design system (WDS) for anticipating, designing, and/or preventing workarounds that bypass systems as designed. A WDS includes a process and an interactive “workaround design tool” (WDT) for identifying and evaluating foreseeable workarounds based on work system theory and a theory of workarounds. This paper summarizes the conceptual background and explains the form, use, and implications of the proposed WDS and WDT. The idea of WDS addresses significant gaps in practice and research. Designers should have methods for identifying likely obstacles and anticipating and evaluating a non-trivial percentage of plausible workarounds. Methods for identifying workarounds might help in training work system participants. Researchers might use WDS to explore why specific responses to obstacles did or did not occur. The lack of methods related to anticipating, designing or preventing workarounds implies that WDS may prove fruitful even though it is impossible to anticipate all possible workarounds

Seeing the Signs of Workarounds: A Mixed-Methods Approach to the Detection of Nurses’ Process Deviations

Workarounds are intentional deviations from prescribed processes. They are most commonly studied in healthcare settings, where nurses are known for frequently deviating from the intended way of using health information systems. However, workarounds in healthcare have only been studied using qualitative methods, such as observations and interviews. We conduct a case study in a Dutch hospital and use a mixed-methods approach that draws not only on interviews and observations, but also on process mining, to detect and analyse eight workarounds that occur in a clinical care process. We contribute to theory by demonstrating that it is possible to use data to determine the occurrence of a rich variety of workarounds found using qualitative methods. Practically, this implies that workarounds that are identified qualitatively can be further analysed and monitored using quantitative methods. Once identified, workarounds also provide an attractive starting point for organisational learning and improvement

Shadow-IT System as a Workaround: A Theoretical Review

The practice of informal IT use, characterizing a hidden or unauthorized, is conceptualized in IS literature as Shadow-IT. This study seeks to understand the conceptual framework that explains the Shadow-IT systems as a form of a workaround representing deviations from existing work systems. Taking workaround theory proposed by Steven Alters in 2014 as a foundational concept in order to examine various aspects of Shadow-IT system as a form of a workaround and the hazards associated with its use. A comprehensive review of a theory of workarounds is systematically organized to inform about the theory and its contributors; its origin and development over time; the intellectual traditions and research milieu in which the theory can be applied. A possible framework is provided for future research to understand organizational challenges in management control and information security as an effect of a Shadow-IT usage utilizing the concepts of workaround theory

Conceptualizing Workarounds: Meanings and Manifestations in Information Systems Research

We reviewed papers in core IS outlets that defined the term workaround or presented an example of a workaround. In the analysis, we used Ogden and Richard’s triangle of reference as a theoretical framework to analyze the relationship between 1) the term workaround; 2) theories, definitions, and use of the term; and 3) their empirical basis and empirical workaround behavior that the papers describe. First, we summarize the existing theoretical insights regarding workarounds and investigate their validity. Second, we show that studies have defined and used the term workaround differently to the extent that they have not always applied it to the same empirical phenomena, which raises questions about some theoretical insights’ validity. Third, we suggest a definition for workarounds that we inductively derived from empirical accounts of workaround behavior and, therefore, that adequately describes how researchers commonly use the term and makes it possible to distinguish workarounds from other similar phenomena

Engineering Enterprises for Emergent Change

This paper uses work system theory (WST) and two of its extensions to provide an integrated perspective on engineering enterprises for emergent change. This paper starts by explaining six basic assumptions and distinctions related to emergent change. It introduces four frameworks or models related to WST including the work system framework, work system life cycle model, a theory of workarounds, and a work system metamodel. It shows how each framework or model can help in identifying different aspects of engineering for emergent change and also can be the basis of guidelines for that purpose. Overall, this paper provides a unique way to think about the engineering of enterprises. In addition, it explains a combination of concepts and frameworks that provide a path toward engineering for emergent change