Standardization of Work: Co-constructed Practice

Abstract

There is strong pressure to achieve greater uniformity, standardization and application of best practices in the service professions, a sector that is growing in presence and importance. At the same time, there is a conflicting demand for the delivery of high- quality ( or high- priced or " knowledge-intensive") specialized or localized services. Our article analyzes information systems- enabled standardizing of service work through an in-depth interpretative study of an ongoing standardization initiative within the field of nursing. Nursing provides a graphic illustration of the dilemmas involved in the standardization of service work. In nursing, standardization is commonly a feature of projects to improve both efficiency and quality in health care. In contrast to the dominant conception of standardization as a largely top- down, imposed process, we offer a view of standardization as incomplete, co-constructed with users, and with significant unintended consequences. The article contributes by ( a) developing a theoretical perspective for the standardization of information- system-embedded service work and ( 2) providing operational and practical implications for system design and health care management.

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