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Documents in Place: Demarcating Places for Collaboration in Healthcare Settings

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Abstract

The notion of place often connotes our understood reality populated with people, practices, meanings, and artifacts. This paper suggests that documents, whether electronic, paper-based, or set in stone, offer important insights into how people establish and maintain places for communication and coordination. Data from an ethnographic study in a large hospital system illustrates how doctors carefully craft their medical histories in various electronic record systems to demarcate specific places for their communication and coordination with specific collaborators. Such documents serve as portable places, allowing the doctors to navigate a constantly changing landscape of relevant patients, participants, times, and spaces. The documents demarcate such places by pointing out the interdependencies among particular participants, places, and times. Doctors care deeply about these documents and they play a central part not only in securing efficient communication and coordination but also in the socialization of newcomers. A study of the complex interrelationships between documents and place, therefore, offers important insights into organizational environments characterized by distributed and mobile work practices.

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Notes

  1. To protect the privacy of both healthcare providers and patients I have changed all names, dates, institutional identifiers (e.g., record numbers, phone numbers, department names, and institutional names), and sometimes the gender of my informants. The examples of records included in Figures 1 and 2 below are excerpts from field notes that did not contain any patient, clinician, or institutional identifiers. Those identifiers were never copied from the originals in the process of the fieldwork.

  2. For a broader description and history of the documents, work practices and hospital’s and clinics’ organizational arrangements see Østerlund (2004, 2007).

  3. Notice: This and the following figures contain no real patient, clinician, or institutional identifiers.

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  1. School of Information Studies, Syracuse University, 309 Hinds Hall, Syracuse, NY, 13244, USA

    Carsten S. Østerlund

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  1. Carsten S. Østerlund
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Correspondence to Carsten S. Østerlund.

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Østerlund, C.S. Documents in Place: Demarcating Places for Collaboration in Healthcare Settings. Comput Supported Coop Work 17, 195–225 (2008). https://doi.org/10.1007/s10606-007-9064-1

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