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Project Activity 2 - Objectives

By contract to high-reliability organisations, the UK National Health Service appears to have a number of cultural characteristics that may actively work against the provision of dependable delivery of health care. For example:

  1. We lack a no-blame compensation scheme and information on medical errors is therefore likely to be concealed rather than widely disseminated as a learning mechanism.
  2. There are clear divisions between different groups of workers (e.g. doctors, nurses, technicians) and a class system still exists.
  3. The system is dependent on short-term contracts and temporary staff. People therefore often do not have the time to absorb; a culture and there is no explicit enculturation as part of the induction process for new staff.
  4. Basic training of staff differs widely across the sectors (e.g. different medical schools take quite different approaches to medical training) so, unlike the military (say), there are no shared fundamental experiences that are common to all workers in the sector.

All of these makes this a very interesting organisation to study and to discover what cultures and, more realistically, sub-cultures have developed, what mutual trust exists in the system, how this trust (and culture) is supported or undermined by IT systems and the extent that the overall dependable delivery of healthcare is reliant on this trust.  It also poses interesting challenges for the design of IT systems in such organisations and we believe that a critical indicator of the success of this project will be whether or not we can provide support for system designers that allows them to understand how cultural and trust factors should impact their design.

The objective to develop software tools to support system designers is derived from our goal of ultimate exploitability. The ‘selling’ and dissemination of new methods and techniques is incredibly difficult whereas the provision of tools allows he work to be demonstrated and ‘sold’ to a much wider audience. We may therefore have web-based demo versions, downloadable trial tools, etc. Objectives are therefore:

  • To describe the organisational culture in healthcare, its relationships with trust and the relationships between trust, culture and dependability
  • To sensitise designers to the importance of organisational culture and trust and to develop guidelines, methods and techniques for system designers to understand and represent the cultures in organisations where their systems will be used and to propose how an understanding of organisational culture and trust should influence the design of dependable socio-technical systems
  • To develop software systems that embed these guidelines, methods and techniques and that may therefore be used to actively support the systems engineering process for dependable systems.

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