Organisation and change in renal work: a study of the impact of a computer system within two hospitals

Abstract

Renal units exist primarily to dialyse patients with end stage renal failure (ESRF) and to train them to dialyse themselves. An important aspect of the care of renal patients is the regular monitoring and recording of their condition by the nurses and doctors. In consequence, the renal units possess an extensive set of records on each of their dialysis patients. This paper reports on a study of two renal units and the consequences of the introduction of a computerised patient data system. This system was designed to ease the burden on the nurses of manually maintaining the patient records as well as improve the access and analysis of the clinical data for the doctors. The concern of the paper is not whether the system was accepted or rejected but how it came to be utilised and why. Using an approach informed by labour process analysis, this study demonstrates the ways in which the clinical division of labour, in particular the relations between doctors and nurses, shaped the ways in which the computer system was utilised. Copyright © 1990, Wiley Blackwell. All rights reserved