Using Work Domain Analysis to Model the Impact of Digitalization in Intensive Care

The thesis’ objective was to investigate the impact of digitalization in intensive care. A case study was performed on an ICU (intensive care unit) that recently adopted a CIS(clinical information system) that replaced a paper charting system. This meant that the nature of nurses’ work changed since some of their administrative tasks became obsolete due to automation, while other tasks were now performed on a computerscreen instead of written by hand on paper sheets. Direct observations and semi-structured interviews took place at the ICU to understand how nurses had perceived these changes. A thematic analysis was used to make sense of the collected data. Moreover, a work domain analysis (WDA) was performed to investigate the CIS‘s impact on the work system since intensive care classifies as a socio-technical system. Findings showed that the system adoption had been successful and considered as an improvement to the paper charts. The CIS had not had any major negative impact on the way nurses worked. On the contrary, they felt an increase in trust that the product of their work (mainly patient data administration) was more correct. Theresult of the WDA showed that it was possible to see how the CIS had contributed to higher functions and goals in the work system. Moreover, the CIS had increased support for nurses’ work in terms of information presentation, continuity of care,standardization, decision support and care documentation. From a scientific point ofview, this way of using a WDA as an evaluation tool is quite unique and can be seen as an extra contribution of the thesis work