A Case Study of Physicians at Work at the University Hospital of Northern Norway

摘要: Introduction A common argument today is that many organizations have become so complex their knowledge fragmented, difficult to locate and share, therefore redundant, inconsistent or not used at all (consider for instance Zack, 1999). There are also arguments about increased market competition, which make it necessary focus on as an important resource. According these arguments, creation, representation diffusion key mechanisms in ensuring modern companies' organizations' competitive advantages (Blackler, 1995; Davenport Prusak, 1998). Aligned with a relatively high share of the management literature, this associated so-called knowledge-intensive firms workers (read Alvesson, 1995). In way considered property firm specific entity 1995) typically stored large databases externalized codified know-how. At later stage, assumed will be readily reused various contexts firm. Considering concept outlined above both narrow too optimistic. Several studies reported shortcomings such perspective pinpointed essential take alternative broader approach Knorr-Cetina (1999), Atkinson (1995) Hunter (1991), work adheres). From point view, insufficient thing; must rather how people create made sufficiently trusted order across contexts. (1995:45), instance, places emphasis medical production work. This achieved only through content collegial talk, but form talk. Thus creation translation process based journals textbooks (Atkinson, 1995:90-91) includes talks between colleagues clinical lectures; ward rounds; morbidity reviews; surgeon's comments juniors students. The study paper focuses physicians' four different University Hospital Northern Norway (UNN) when they produce discharge letters. UNN letters part hospital's electronic patient record, accordingly placing core most critical information system. contrast traditional view (Alvesson, work, especially practiced hospitals like UNN, highly specialized. It characterized by state-of-the-art knowledge, levels education organizational complexity. As originates from myriad sources, involves summing up thus reusing previous (Berg, 1998:298). underscores importance historical foundation present action future along trajectory. term "trajectory" refers physiological unfolding patient's disease total organization done over course, plus impact those involved its (Strauss et al. 1985:8). trajectories specialized distributed 1985:26; Blume, 1991:17; Atkinson, 1995:7; Reiser, 1984:303). points out extremely interdependent emphasizes role trust expectations another's trustworthiness relevant completion one's own activities depend prior co-operation another person (Lane, 1998:3). Moving beyond simplistic dichotomies, tacit/ explicit representations, I dwell practices rendering (regardless representation) credible, trustworthy. …