Disrupted rhythms and mobile ICT in a surgical department

Purpose: This study presents a study of mobile information and communication technology (ICT) for healthcare professionals in a surgical ward. The purpose of the study was to create a participatory design process to investigate factors that affect the acceptance of mobile ICT in a surgical ward. Methods: Observations, interviews, a participatory design process, and pilot testing of a prototype of a co-constructed application were used. Results: Informal rhythms existed at the department that facilitated that people met and interacted several times throughout the day. These gatherings allowed for opportunistic encounters that were extensively used for dialogue, problem solving, coordination, message and logistics handling. A prototype based on handheld mobile computers was introduced. The tool supported information seeking functionality that previously required local mobility. By making the nurses more freely mobile, the tool disrupted these informal rhythms. This created dissatisfaction with the system, and lead to discussion and introduction of other arenas to solve coordination and other problems. Conclusions: Mobile ICT tools may break down informal communication and coordination structures. This may reduce the efficiency of the new tools, or contribute to resistance towards such systems. In some situations however such "disrupted rhythms" may be overcome by including additional sociotechnical mechanisms in the overall design to counteract this negative side-effect. (C) 2011 Elsevier Ireland Ltd. All rights reserved.