Standardization of work: co-constructed practice

TL;DR

This paper examines how standardization in nursing is a complex, co-constructed process involving users, highlighting its implications for system design and healthcare management.

Contribution

It offers a novel theoretical perspective on standardization as an incomplete, co-constructed process with unintended consequences in service work.

Findings

Standardization in nursing involves co-construction with practitioners.

Unintended consequences arise from standardization efforts.

Implications for system design and healthcare management are discussed.

Abstract

There is strong pressure to achieve greater uniformity, standardisation and application of best practices in the service professions, a sector which is growing in presence and importance. At the same time, there is a conflicting demand for the delivery of high quality or highly priced or knowledge intensive specialised or localised services. Our paper analyses information systems embedded efforts of standardising service work through an indepth interpretative study of an ongoing standardisation initiative within the field of nursing. Nursing provides a graphic illustration of the dilemmas involved in the standardisation of service work. In nursing, standardisation is commonly a feature of projects to improve both efficiency and quality in health care. In contrast to the dominant conception of standardisation as a largely topdown, imposed process, we offer a view of standardisation as incomplete, co-constructed with users and with significant unintended consequences. The paper contributes by developing a theoretical perspective for the standardisation of information-system-embedded service work and operational and practical implications for system design and health care management.