Suelette Dreyfus

One hundred tasks an hour: An observational study of emergency department consultant activities

Objective: To determine work activity patterns undertaken by ED consultants.

The Relationship between Transparency, Whistleblowing, and Public Trust

This chapter uses empirical evidence of public attitudes toward a specific type of transparency reform – facilitation and protection of ‘whistleblowing’ – to seek out a more complete picture of the role of transparency in sustaining trust.

Tailoring patient information to encourage patient engagement

This paper proposes a new method for tailoring health information based on an individuals dominant attitudes and information processing style which can be digitally operationalised and delivered direct to the patient. This individualised approach is based on principles previously used as the basis for mass-marketing campaigns, including smoking and other public health issues - but not previously used for structuring treatment recommendations in individual patient consultations. In previous work we have shown that patient understanding of their medical condition is influenced by whether a medical report is expressed in their preferred information processing style or expresses their dominant motivational attitude. In this work we build on these findings to examine the connection between a patients perceived understanding of the content of a medical report and their willingness to actively engage with their doctor. Because engagement has been linked to patient compliance, this has important implications for patient adherence to treatment.

Tick a box, any box: a case study on the unintended consequences of system misuse in a hospital emergency department

Long patient waiting periods and a high administrative load plagued the Emergency Department of a major Australian hospital. In response, the department installed a new information system. Technically, the new system worked perfectly. Yet, within 9 months the department suffered a catastrophic loss of patient revenue. The financial disaster led to senior doctors being forced to abandon their medical duties in order to correct complex administrative problems. It triggered a complete review of training, task and role prioritisation. This case study describes a major and costly error resulting from the use of the newly implemented hospital IS. It traces how the error came about, how the hospital responded and what hospitals could do when deploying new systems to prevent such errors. We examine hospitals as hierarchical organisations with financial and organisational goals that sometimes conflict. The case presented explores the cultural setting of the IS roll-out, where medical professionals are accustomed to autonomy over their work practices and are disinclined to engage in activities that they see as interfering with patient care. The case highlights issues in respect to deployment and adoption. These include user training and consideration for the existing organisational culture and stakeholder practices when implementing large systems that cause significant organisational change. The discussion can be structured around stakeholders’ behaviour, user resistance, goal conflicts, power shifts, training, division of labour and work flow management. In addition the case raises governance questions: What mechanisms can be used in IT projects to prevent errors like this from arising?