Implications of transforming the Patient Record into a Knowledge Management System

In this paper I theorize about how transforming the interpretative scheme for what a patient record is might restructure a health care setting. The observations presented here were obtained when I during three years followed implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed and interpreted within a framework combining theories about knowledge management with concepts from structuration theory and cognitive theories about schema-use, representations and sense-making. The findings indicate that thinking about the patient record as a knowledge management system might start a horizontal and vertical movement, a movement of coordination and enhancement. I propose that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.interpretative schemes; anesthesia patient record; knowledge management system; knowledge management; structuration theory

How to manage people who think. A structural approach.

This is a paper about creativity, diversity and other often used buzzwords. It is also a paper about how to manage people who think. Today we live in a world in which computers and mobile phones have become the key artifacts. Nokia´s slogan ”connecting people” expresses in a brilliant way what it is all about. When we connect people information is transfered and new knowledge hopefully created. And innovations, ideas and individuals are central for everything that takes place. We are all supposed to be flexible, exercising our knowledge in a setting characterized by diversity. This setting is also characterized by paradoxes that I will write more about further down. But transformations such as the globalization and implementing of new information technology race crucial questions about how to deal with a changing economic landscape and new mindsets and changing attitudes. The pages that follow is based on extensive reading of the literature and participating in many conferences and work-shops. In addition to this I have interviewed managers and employees at Electrolux, Ericsson, TeliaSonera and The Confederation of Swedish Enterprise. I have asked people in the above mentioned organizations how they react to concepts such as the knowledge society and the practice of managing knowledge, creativity, diversity and flexibility. This paper is written with a Scandinavian perspective. It is also written with a social constructionist perspective. The theoretical framework includes theories about knowledge management, structuration theory and cognitive theories. The findings are based on interpretative research and I have systematically reflected over the material I have collected. I direct myself towards people in business who think and worry about the future. The purpose is to inspire to further discussions about these very important matters.Knowledge management; structuration theory; knowledge society; globalization; creativity; diversity; flexibility.

The Patient as a construction and a non-participant member of a change-process.

The contribution of this paper is a discussion about how the patient as a phenomenon is constructed and used by employees for different purposes, enabling and inhibiting change. The results are based on a three year case study in which data has been collected with interviews and observations. They have then been analyzed and interpreted within a framework consisting of theories about thinking collectives, structuration, information and knowledge management. The findings indicate that “the patient” has implications for how project management is conducted and a patient record upgraded at the anesthesia and intensive care unit of a hospital.the patient; anesthesia information management; constructionism; thinking collectives; knowledge management; structuration.

How small should an economy's fiscal deficit be? - a monetary programming approach

The author describes a spread-sheet planning model to help determine the government deficit consistent with a policymaker's"vector"of principal macroeconomic objectives (including real GDP growth, inflation, exchange rate, and international reserve accumulation). The model focuses on the monetary accounts, applying balance-of-payments forecasts formulated separately, but based on the same macroeconomic objectives. The model is a consistency exercise, intended as part of a broader consistency exercise for a given macro-economy. It offers one more perspective on the question of how large a government deficit should be - a perspective that can be used in conjunction with others. For each forecast period, the model determines consistent period-end and period-average stocks for the economy's outstanding central bank assets, and liabilities and, government obligations. I applies forecasting assumptions about interest rates to forecast central bank profit-and-loss flows, and takes account of these in determining the overall flow of resources that would be available to finance the government deficit. An annex describes a (purely illustrative) simulation carried out during 1999for Ecuador.Banks&Banking Reform,Economic Theory&Research,Payment Systems&Infrastructure,International Terrorism&Counterterrorism,Environmental Economics&Policies,International Terrorism&Counterterrorism,Environmental Economics&Policies,Economic Theory&Research,Economic Stabilization,Macroeconomic Management

Knowledge structuring-Knowledge domination. Two interrelated concepts

“Sociology for me is not only about the big institutions, such as governments, organizations, business firms or societies as a whole. It is very much about the individual and our individual experiences. We come to understand ourselves much better through grasping the wider social forces that influence our lives.” ( Anthony Giddens, published at www.polity.co.uk, a leading social science and humanities publisher. ) This quotation helps identify one reason for integrating ideas about knowledge management with concepts from Anthony Giddens structuration theory in the theoretical framework that I use as an analytical tool in this research. Structuration theory concerns itself with the “social forces that influence our lives” and these forces interest me. In the same article Giddens continuous: ”We live in a world of quite dramatic change…There are three major sets of changes happening in contemporary societies and it is the task of sociology to analyze what they mean for our lives today. First there is globalisation….The second big influence is that of technological change. Information technology is altering many of the ways in which we work and in which we live. The nature of the jobs people do, for example, has been transformed….The third fundamental set of changes is in our everyday lives. Our lives are structured less by the past than by our anticipated future”. In this paper I agure that there is a continous structuring going on in society. I therefore concern myself with a pair of twin concepts that are interrelated. The first one is knowledge structuring; the second is knowledge domination. These two concepts are of vital importance when trying to understand, assess and monitor implications of transformations of work processes and tools at work.Knowledge structuring; knowledge domination; knowledge management; structuration theory; cognitive theories; transformations; information technology; globalisation.

Restructuring an Empire. A narrative study of the turnaround of the telecom company Ericsson.

The turnaround of the telecom company Ericsson is considered a unique chapter in Swedish business life in terms of complexity, size and speed. This paper focuses on how some of the interpretative schemes of the employees were transformed during the turnaround and the organizational setting restructured. Instead of making a conventional study of a change process this study uses narrative method and explores the transformation through the eyes of four people. In this way this study hopes to be able to present a broader picture of some of the organizational learning that takes place during events like this, since storytelling is crucial when people make sense of their everyday life. A narrative analysis approach will not result in the one “true” account of a phenomenon. However, narrative analysis can provide detailed insights into individual informants understanding of events and highlight similarities and differences in interpretations that are interesting also for outsiders to take part of. The findings indicate that not only the interpretative schemes for how to run the company were transformed but also how the employees view the world.interpretative schemes; management; narrative method; structuration theory; turnaround; telecom; Ericsson.

The decline and fall of Brazil's Cruzado

Includes bibliographical reference