Routinizing Workarounds : The Case of a Mandated PDMS in Critical Care

Sammanfattning: Workarounds are an emerging area within information systems (IS) research where contributions are increasing but there seem to be different views on what constitutes a workaround. While some aspects of workarounds have attracted considerable research attention and show a high degree of consensus, other aspects contain scarce or conflicting findings. This thesis aims to investigate what constitutes a workaround and how routine dynamics can contribute to our understanding of workarounds in mandatory contexts.I first performed a concept-centric literature review based on literature that has influenced or been published in the former Association for Information Systems (AIS) Senior Scholars’ basket of eight journals and official AIS conferences. I also developed a conceptualization of workarounds from described workaround behaviour in the previous research.With that backdrop, I studied workarounds during the implementation of a Patient Data Management System (PDMS) in two critical care units at a Swedish hospital. A PDMS is a health information system designed to automatically retrieve data from bedside equipment at critical care units and present these in a structured format to improve documentation, manipulation, and interpretation. Usage of the PDMS was truly mandatory where the staff were required to use the system to keep and perform their jobs. Using observations and interviews, I collected data which were analysed using reflexive thematic coding.My research contributes to IS literature in several ways. I develop a conceptualization and definition for workarounds inductively derived from empirical accounts of workaround behaviour that make it possible to distinguish workarounds from other similar phenomena. Then I show how routine dynamics helps us to better understand the internal dynamics of workarounds and the role of artefacts, power, and resistance, and provides us with tools to, for instance, remove redundant workarounds. I also provide thick empirical descriptions that make it possible for researchers to engage with, and question, my assumptions and the applied theoretical framework.