How do Sociomaterial Networks Involving Large-Scale Automation, Come into Being, Persist and Change Over Time, Within a Healthcare Environment?

Shaw, Christopher (2014) How do Sociomaterial Networks Involving Large-Scale Automation, Come into Being, Persist and Change Over Time, Within a Healthcare Environment? Doctoral thesis, Northumbria University.

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Abstract

The aim of this thesis is to develop a theoretical model to explore how sociomaterial networks, involving large-scale automation, come into being, persist and change over time, within a healthcare environment. It does so by
bridging the gap between design, implementation and use of large-scale pathology automation (LSPA) within two United Kingdom (UK) National Health Service (NHS) laboratories. A longitudinal, multi-site, ethnographic approach was used, along with semi-structured interviews, template analysis and participant observation of LSPA ‘in-practice’.

This research has suggested that design features, embedded within the material properties of LSPA, were purposefully intended to bring about organisational change. In both user organisations, the material affordances of LSPA resulted in anticipated skill mix changes. However, material constraints required the enforcement of changes to organisational routines, creating operational difficulties, which were then subsequently transferred across organisational boundaries by the researcher/manager. The identification of these sociomaterial affordances and constraints, in conjunction with humans acting as boundary objects, had the unintended consequence of influencing strategic decision making and initiating structural and cultural change.

The development and practical application of the resulting SociomANTerial model allowed the researcher to trace the analytical history of these organisational changes over time and consider the impact of broader social structures such as power. Ultimately it is suggested that a greater emphasis on collaboration between users, designers and corporate agents will result in more innovative approaches for technology adoption and improved organisational design.

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