Occupational adaptation to computerized medical information systems

This paper explores the effects of computerized medical information systems on the occupational communities of health care professionals in hospitals. Interviews were conducted with informants from the pharmacy and nursing departments at two hospitals currently using medical information systems for communicating physicians' medication orders from the nursing station to the pharmacy. Results showed changes in tasks for both pharmacy and nursing, resulting in increased interdependence between the two departments. This interdependence was accompanied by improved communication and cooperation, providing an opportunity to encourage better working relationships between departments. The use and maintenance of the common computerized data base became a superordinate goal for the two groups, with the computer system itself as the topic of communication.     

Narratives of ICT and Organizational Change in Public Administration

In the last decade the implementation of computerized technology and advanced information systems in public administration has gathered speed. The purpose of this article is to explore the ways in which these changes might be gendered by analysing different narratives of digitalization and organizational change in public administration. The empirical findings indicate that resistance to information and communication technology is explained away by managers as reflecting women's low computer maturity, while the narratives of the case‐workers themselves reflect their resistance to deskilling and simplified work specifications, as well as their experience of a shift in the work object — from working with human beings to working with electronic information. The findings indicate that the increased use of information technology genders resistance to degradation as a feminized fear of technology and low computer maturity.     

Factors in Acceptance of Advanced Information Technology Among Social Workers

Summary

Advanced information technology such as diagnostic programs, decision support systems or therapeutic computer games are likely to have far-reaching effects on the nature of social work practice, on the condition that they can be accepted by rank and file workers in human services organizations. This exploratory study was designed to develop a valid instrument that can test the extent to which social workers are willing to use the three most common types of advanced information technology: (1) computerized assessment package (CA), (2) decision support system (DSS), and (3) therapeutic computer games (TG). The instrument was field-tested with 74 Israeli social workers. Social workers clearly differentiated between the types of information technology with preference for therapeutic computer games (TG, DDS, CA, mean acceptance = 4.14, 3.91, 3.47, respectively). The differences between TG and CA, and between DDS and CA were statistically significant in paired t-tests (p = .000 and .003 respectively).     

Implementing the Crossover Youth Practice Model in diverse contexts: Child welfare and juvenile justice professionals' experiences of multisystem collaborations

This study takes advantage of a unique opportunity to observe structural and psychosocial processes of multisystem collaborations primarily from the perspectives of professionals attempting to bring about change in practice with crossover youth. The involvement of maltreated youth in the juvenile justice system is a persistent problem that can compound vulnerable youths' risks for problematic developmental outcomes. Youth outcomes may be improved when professionals in the juvenile justice and child welfare systems communicate and collaborate more effectively in case assessment, planning and management. The Crossover Youth Practice Model (CYPM) is an attempt to translate these and other research findings into practice largely through multisystem collaborations. This study presents an approximately two year-long, ethnographic inquiry into professionals' experiences of CYPM implementation in five diverse counties in a Midwestern state. During individual interviews, participants consistently described structural changes involving improved service provision to youth and families, and procedures and legal mandates for sharing information across departments. They also discussed psychosocial changes including improved professional support, strengthened relationships with other professionals and positive shifts in their ways of thinking and feeling about youth and their families. Participants also experienced implementation challenges including inadequate support and training of front line workers, distinguishing core features of the multifaceted model, and some issues in engaging families and key community stakeholders. Comparative case analyses across five counties suggest that systems change processes vary across and within local contexts. Implications for the implementation of systems change practice models in diverse contexts with professionals serving in various roles are discussed.     

Using the Systems Development Life Cycle for Computer Applications in Human Services

This paper examines the systems development life cycle (SDLC) as one major way to improve successful development, implementation and use of computer applications in human services. The systems development life cycle of a hospital-based case management system is described to demonstrate a successful system. Issues of the uniqueness of human services applications, the use of microcomputer technology, and prototyping as an alternative to the SDLC are analyzed in relation to the case study.     

Diversity-The Competitive Advantage

ABSTRACT

There is increasing pressure on social service agencies to produce “results,” and often agency computer information systems are associated with efforts to do so. The current study explores worker characteristics that may interact with organizational factors in influencing data system utilization. A survey of 245 community social workers serving as field instructors was conducted. Worker skill and experience with computers accounted for a large part of the variance on the utilization of information systems followed by the user-friendliness of the system and the workers' beliefs that data are useful in their work. The findings suggest that organizations seeking to increase worker utilization of information systems will need to focus on enhancing worker's computer skills as well as assuring that the information is easy to use and is perceived as useful by workers.     

Use of information systems in social work – challenges and an agenda for future research

ABSTRACT

In the age of digitalisation social work is transforming. With the increased use of information systems, social workers are meeting new professional challenges. In this paper, we report findings covering a nine-year longitudinal study on critical issues in the use of a Case Management System in a Swedish social work agency. The study includes a stakeholder-based evaluation, interviews and document analysis. Comparing the evaluation findings with the literature helped us identify six areas in need of intensified research: (i) Usability and interface design; (ii) Mismatch between social conceptualisation and system conceptualisation of the case; (iii) Skills and training for information systems use; (iv) Statistical production for accountability and quality assurance; (v) Terminology for interpersonal understanding; (vi) IT Governance. As can be seen from the areas above, this kind of research depends on professional knowledge from the social work field – but also from the field of information systems. Hence, we suggest deeper collaboration between the two areas of knowledge in order to scrutinize the complexity of social work information systems. Clearly, the intersection of social work and information systems is a neglected research area, and we attempt to contribute by providing guidance for intensified research and practical knowledge generation.     

24 Hours in a Day: A Listening Update to the Time Studies

Time is an important communication variable that has been impacted by new technology and changed the way people communicate. This study of communication time use by college students provides an update to earlier studies by factoring in computer and telephone use—media that have forced a multitasking approach to communication. Undergraduate students (N = 680) at a large Eastern university reported that they spend most of their time (48%) communicating with their friends, followed by time in school, at work, and with families. Students spend 24% of their time listening, 20% speaking, 13% using the Internet, 9% writing, and 8% reading.     

Experiential Exercises for the Development of Computer Literacy Among Social Work Undergraduates

Summary

This paper describes exercises and assignments used to promote computer literacy among social work undergraduates. These exercises were used as course assignments in an elective course for seniors, “Information Technology and Human Services.” Exercises met four criteria: (1) they assume no previous computer experience or knowledge, (2) they are directly related to human services practice, (3) they promote mutual support, (4) they are experiential. Exercises include use of word processing, database, spreadsheet, electronic mail, privacy invasion, shopping for a computer system, and impact of information technology on the larger society.

The potential placement of computer literacy exercises in the social work curriculum is discussed. It is suggested that a single experiential course best meets the need for promoting computer literacy among social work students.     

Going tobacco-free on 24 New York City university campuses: A public health agency's partnership with a large urban public university system

ABSTRACT

The New York City Department of Health and Mental Hygiene partnered with the nation's largest university system, the City University of New York (CUNY), to provide technical assistance and resources to support the development and implementation of a system-wide tobacco-free policy. This effort formed one component of Healthy CUNY—a larger initiative to support health promotion and disease prevention across the university system and resulted in the successful introduction of a system-wide tobacco-free policy on all CUNY campuses. Glassman et al (J Am Coll Health. 2011;59:764–768) published a blueprint for action related to tobacco policies that informed our work. This paper describes the policy development and implementation process and presents lessons learned from the perspective of the Health Department, as a practical case study to inform and support other health departments who may be supporting colleges and universities to become tobacco-free.     

Information Technology Foundations for Professional Social Work Practice

Summary

Graduate social work curricula and human service organizations (HSOs) are behind in the use of current information technology (IT) for professional social work practice. Knowledge and use of computer run client advocacy based management information systems (CAMIS) are key prerequisites to the management of professional practice in HSOs. Discussion is augmented by focus on an automated CAMIS (IBM-PC, Rbase) used in the classroom as well as agency settings. Software demos are available.     

New Ways of Working: does flexibility in time and location of work change work behavior and affect business outcomes?

In the changing modern economy some new factors have been addressed that are of importance for productivity and economic growth, such as human skills, workplace organization, information and communication technologies (ICT) and knowledge sharing. An increasing number of companies and organizations are implementing measures to better address these factors, often referred to as 'the New Ways of Working (NWW)'. This consists of a large variety of measures that enable flexibility in the time and location of work. Expectations of these measures are often high, such as a reduction in operating costs and an increase of productivity. However, scientific proof is still lacking, and it is worth asking whether al these implementations actually cause a change in work behavior and effect business outcomes positively. This article describes a case study of three departments (total of 73 employees) that changed from a traditional way of working towards a new way of working. Questionnaires and a new developed objective measurement system called 'work@task' were used to measure changes in work behavior (i.e. increased variation in work location, work times and a change towards NWW management style) and the effect on business objectives such as knowledge sharing, employees satisfaction, and collaboration.     

Emergency departments and street-involved youth: factors influencing utilization

Homeless youth often have untreated health problems and experience barriers to care. Existing evidence suggests that homeless youth use emergency departments (EDs) more frequently than other youth. We hypothesized that street youth with access to primary care services would be less likely to utilize EDs for health care. Data were drawn from a study of housing security and changes to it over time among 150 youth (16–20 years) recruited from service agencies for street-involved youth. Our findings show that those with access to primary care were actually more likely to use the ED, suggesting that access may encourage further engagement with the health care system. Findings support the need to better understand why access to primary care increases ED use and what could be done to change this pattern.     

Heads in the Cloud: An Example of Practice-Based Information and Communication Technology in Child Welfare

Changes in information and communications technology (ICT) in human services have accelerated rapidly and have elicited academic concern about the impact on practice, changes in approaches to implementation, and a shift to user-led development. This article describes the development of ICT by a nongovernment child welfare agency over the past two decades. It is guided by a social constructionist view of technology in which technology is shaped by social factors, but in turn shapes the “social” implementation as requiring the integration of two distinct technologies: a standardized framework for practice and the computer. Both technologies had to be carefully aligned to workplace culture, but the interests of workers have not been allowed to dominate those of and children and families. The organization of work has had to change. This article explores the agency’s experience drawing on theories of implementation of ICT in human services.     

The Application of Artificial Neural Networks for Outcome Prediction in a Cohort of Severely Mentally Ill Outpatients

SUMMARY

Social workers and other mental health workers lack clinical decision support tools to predict which clients are at greatest risk of psychiatric rehospitalization. Artificial neural networks (ANNs), are computer decision support tools that make prediction and classification decisions based on accumulated experience and information contained in successfully solved cases (correct decisions). This study evaluates the use of ANNs in predicting rehospitalization of severely mentally ill outpatients. Eight Bayesian ANN models achieved correct prediction rates ranging from 75% to 93% for two prediction conditions. These results support the utility of Bayesian ANN models in the development of clinical decision support tools.     

Connecting Clinical Information Processing With Computer Support

Clinically oriented computer systems require compatibility with the information processing that typifies clinical work. This paper summarizes some of the research that can be applied to such processing and uses the summary to suggest likely errors. Alternative means to correct for such errors are also summmarized leading to an emphasis on decision support systems that integrate human and computer information processing strengths. An example concerning long-term mental illness is used for illustration.     

Looking After Children: assessing outcomes in child care. The experience of implementation

A Department of Health initiative has supported the implementation of Looking After Children in over 90 per cent of local authorities in England. The process has required major organisational change and new values and attitudes towards children looked after away from home. Difficulties arise where management and monitoring systems are not available to support these wider changes and to assess the quality of practice. Nevertheless clear benefits to using the system can be identified. Pilot projects in Sweden, Canada and Australia provide an opportunity to compare experiences internationally; strong parallels are evident in some of the current issues facing child welfare.     

Transformative capacity, information technology, and the making of business 'experts'

This paper explores the making of experts and the basis of claims to expertise in corporate organisational settings. The performance of expertise within organisations is increasingly associated with the implementation and use of integrated business information systems which purport to abstract the world into an informational form to make businesses run more efficiently. We argue that as these systems are put to work to replace the calculations of human experts, we are required to rethink how expertise is constituted as a political and performative process. We focus on the provisos and qualifications that surround the use of calculative techniques and the worries and scepticism over the correctness, accuracy and interpretation of numbers and figures derived from systems of calculation. Rather than identifying expertise as the capacity to make calculations and to abstract ‘representations’ from the ‘real world’, a job increasingly done by information systems, we find expertise being performed in the transformation of things of different orders which enables representations to be returned to the world through allusions to their transformative effect.     

Psychotherapy with Deaf and Hard of Hearing Individuals

ABSTRACT

This qualitative study explored the subjective experiences of deaf and hard-of-hearing individuals in psychotherapy. Which culturally syntonic considerations are necessary for effective psychotherapy with deaf and hard-of-hearing individuals? The findings support the literature on multiculturalism and deafness that entail effective communication, empowerment processes, cultural sensitivity, therapist role flexibility, the imparting of information, and the development of a positive therapeutic relationship. The data focuses on the experience of communicating rather than focusing solely on the acquisition of content as well as the understanding the clinical dynamics of the transcultural relationship in order to make effective use of the social work relationship in treatment. The findings of this study add richness and depth to the existing literature on psychotherapy, with emphasis on the experiential processes of treatment.     

Measuring outcomes in family support services (a case study using respite care)

Measuring outcomes in family support services is a relatively new area of social research. This study aimed to explore the use of respite care (brief planned periods away from home with the same carers over several months) as a family support service to help prevent long term family breakdown. It studied the service from the perspectives of all those involved in it—social workers, carers, parents and children–and was funded by the UK Department of Health as part of a series of studies commissioned to explore the implementation of the English Children Act law and theory.