Health care categories have politics too: Unpacking the managerial agendas of electronic triage systems

Abstract

While investigating the resistance to the electronic triage system, ETRIAGE, at the emergency department of British Columbia Children's Hospital, we revisit the well-known CSCW-debate about THE COORDINATOR concerning the politics of standardized categories. Examining the history as well as the design of ETRIAGE, we reveal four basic assumptions about triage work in emergency departments, which are reflected in the design of the ETRIAGE application and related to the managerial agenda of controlling costs in hospitals. We find that ETRIAGE has an embedded surveillance-capability, which challenges the professional authority of nurses' work and removes discretion from the individual. We argue that the resistance towards ETRIAGE should be understood in terms of experienced nurses' disputing the assumptions about their professional practice that are embodied within such systems rather than general resistance to change or resistance to technology. © 2007 Springer.