Host: Welcome to A.I.S. Insights — powered by Living Knowledge. I’m your host, Anna Ivy Summers, and with me today is our expert analyst, Alex Ian Sutherland.
Host: Alex, today we're diving into a study titled "To Use or Not to Use! Working Around the Information System in the Healthcare Field". It investigates a really interesting paradox: why highly skilled nurses utilize workarounds for their electronic medical record system, even when they generally perceive the system as useful and effective.
Host: Alex, this sounds like a familiar story for many businesses. Companies invest millions in technology, but employees find ways to bypass it. What's the big problem this study highlights?
Expert: Exactly, Anna. Healthcare organizations have spent billions on Electronic Medical Record, or EMR, systems to improve efficiency and patient safety. The puzzle this study addresses is why employees who actually accept and value a system still engage in workarounds. This practice can undermine the technology's benefits and introduce serious risks to things like patient care and data security.
Host: So this isn't the classic case of users resisting a new or badly designed system?
Expert: That's what's so compelling. The study looked at a hospital using an award-winning, in-house developed EMR system—one that scored the highest possible rating for its adoption and use. Yet, they found that 23 out of the 24 nurses interviewed regularly worked around it. It shows the problem is often deeper than just the technology itself.
Host: That’s a shocking statistic. How did the researchers get to the bottom of this?
Expert: They used a qualitative case study approach. Over 18 months, they conducted in-depth interviews with 24 nurses at a large hospital. This allowed them to move beyond simple surveys and really understand the day-to-day pressures and the thought processes behind the nurses' decisions.
Host: So what were the key findings? Why are these nurses bypassing a system they actually like?
Expert: The primary driver was a simple, powerful principle the nurses often repeated: "Patient before system." In a high-pressure, fast-paced hospital environment, their absolute priority is direct patient care. They use workarounds—like sharing passwords, or writing notes on paper to enter into the system later—to save critical seconds and minutes that they can then spend with their patients.
Host: It’s a conflict between official procedure and on-the-ground reality. What else influences that choice?
Expert: The decision is strongly influenced by group norms and habit. If an entire team shares a single logged-in computer to save time during an emergency, it becomes standard operating procedure. One nurse said of sharing passwords, "It is against policy, but we all do it." It becomes normalized.
Host: And there's a psychological element at play too, something called 'hyperbolic discounting'?
Expert: Yes, and it's a crucial concept for any manager to understand. Hyperbolic discounting is our natural tendency to value an immediate reward more highly than a future one. For a nurse, the immediate, tangible benefit of saving two minutes to help a patient in pain far outweighs the abstract, long-term risk of a potential policy violation. The present need simply feels more urgent.
Host: This is the critical part for our business listeners. While the context is healthcare, this feels universal. What's the key takeaway for leaders in any industry?
Expert: The most important takeaway is that workarounds aren't just a problem to be eliminated; they are a source of vital information. Managers shouldn't react with a zero-tolerance policy. Instead, they should see these behaviors as signals that point to a gap between how work is designed and how it's actually performed.
Host: So, how should a leader approach this?
Expert: The study suggests managers should learn to categorize workarounds. Think of them as 'Good, Bad, and Ugly'. 'Good' workarounds are diagnostic tools. They show you exactly where your official process is inefficient or where your software isn't aligned with reality. They’re a free audit of your workflow.
Host: And the 'Bad' and 'Ugly'?
Expert: 'Bad' workarounds introduce significant risks, like compromising data security. These need to be addressed immediately, but not just by banning them. You need to provide a better, official alternative that solves the underlying problem. The 'Ugly' workarounds are the deeply ingrained habits. They are hard to change and require a more nuanced approach involving training, incentives, and changing team culture, not just writing a new rule.
Host: So the message is: don't just punish the workaround, understand its purpose.
Expert: Precisely. By studying these workarounds, leaders can get incredible insights into how to improve their systems, processes, and ultimately, get the real value from their technology investments.
Host: A fascinating and practical insight. To summarize, even good systems will be bypassed if they conflict with an employee's core mission. This behavior is driven by a desire to be effective, reinforced by team culture, and justified by our own psychology.
Host: For business leaders, the lesson is clear: treat workarounds as valuable feedback to make your organization better. Alex, thank you for making this complex study so clear and actionable for us.
Host: That’s all for this episode of A.I.S. Insights. Join us next time as we continue to explore the crucial research shaping business and technology today, all powered by Living Knowledge. Thank you for listening.