The DISA team had a workshop with their reference group earlier in March, to prepare for the last stretch of the project: creating the eWorkEnvironment framework. To start with, the reference group, representing both people working in healthcare and other researchers, was given an update of the last developments of the project. Both Diane Golay’s presentation about nurses’ invisible work and Thomas Lind’s presentation of an interview study with the people responsible for acquiring, implementing and maintaining the systems inspired a lively discussion about further problems and in particular the gaps between the different actors: decision makers, IT professionals and nurses, and how usability falls in these gaps. The survey presented by Minna Salminen showed that younger nurses sometimes can be more negative to increased use of ICT, and that attitudes to a digital tool are not only grounded in attitudes to technology, but also, for example, in attitudes to patients and patient empowerment.
The afternoon was spent in discussions where the DISA team got several inputs to their original ideas of what should go into the eWorkEnvironment framework. The definition of the target group was one of the tricky questions discussed: “Decision makers” in the process of acquiring and implementing digital tools for healthcare are the target group, but they can be found at many different levels and in many different roles in the healthcare hierarchy and, in addition, the organization varies between different regions in Sweden. Once these “decision makers” are conceptualized, strategies are needed to make them interested in and observant to the effects of digitalization on nurses’ working environment, for them to be interested in the eWorkEnvironment framework in the first place. The reference group had valuable ideas of what strategies could be used to get the message through.
While the message from the DISA team has been that nurses need to be heard when implementing new digital systems, the reference group pointed out that also outside eyes are needed in the process: in addition to nurses’ experiences, outside eyes may help to verbalize aspects that may go unnoticed by nurses themselves.
The DISA team and the reference group agreed that a major problem is the “parallel pipelines” approach to digitalization: there are several actors who all work for more digitalization, but nobody has a whole picture on how the situation looks from the daily working perspective of a nurse and the different systems are not integrated. The normal way of working in projects exacerbates the situation: each introduction is a project of its own, that not only is not connected to other projects running in parallel, but is also often terminated long before the new digital tool has become a natural and useful part of nurses’ daily work.
Having a diverse and competent reference group is certainly an important asset for a project! We are grateful for their time – and are further inspired to try to give something in return, both for the healthcare staff and for the scientific community.