Teresa Schilder-Knudsen and Louise Færgemann: Articulation of Patient Trajectories: Articulation Associations across Boundaries. Master Thesis in Danish [Samordning af patientforløb: Samordningssammenhænge på tværs], IT University of Copenhagen, November 2004.
The objective of this thesis is to explore the articulation work that arises within cooperative work surrounding patient trajectories. On the basis of an empirical study we identify the conditions of the articulation work and its fundamental characteristics. By applying a CSCW approach it is revealed in the analysis that fundamental concepts within the CSCW terminology (the conceptual framework of Schmidt et al.) are not able to meet and accommodate the complexity of this specific articulation work. Along with the analysis we therefore suggest a refinement of the conceptual framework of Schmidt et al.
The theoretical refinement of this framework is based on an empirical study of the articulation work related to the period of gestation. This has been examined primarily on the obstetrical department at Rigshospitalet, the State University Hospital in Copenhagen. The theoretical contribution includes: (1) A distinction between local and global cooperative lvork arrangements in relation to a common field of work. The former is, moreover, reserved for dimensions with relatively definite limits. (2) The term articulation association is introduced to accommodate the dynamics in the articulation work. (3) The concept generalized dependence is introduced as a refinement of the present concept mutual interdependence. By subsequently applying the refined conceptual framework to the empirical field study it is identified that coherence in patient trajectories appears on a micro-level, on a macro-level as well as on a prospective level. The refined conceptual framework thus contributes to a better understanding of the coherence as it appears in patient trajectories. Finally, the thesis briefly presents challenges for analysis and design of computer systems within the perspective of the refined theoretical framework.