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Socio-technical Transformations in Care Practices

Investigating the Implementation of Social Alarm Systems in Nursing Homes

Time: Wed 2021-12-01 09.00

Location: T52, Hälsovägen 11C, Huddinge

Language: English

Subject area: Technology and Health

Doctoral student: Fangyuan Chang , Teknisk vårdvetenskap, Technology in Health Care

Opponent: Professor Uno Fors, Stockholms universitet

Supervisor: Professor Britt Östlund, Teknisk vårdvetenskap; Assistant Professor Sanna Kuoppamäki, Teknisk vårdvetenskap; Andrea Eriksson, Ergonomi

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The worldwide shortage of qualified care workers along with the increasing need for elderly care services has restrained the capacity of nursing homes to offer their residents high-quality care services. Along with digitalization, policymakers believe that technological advancements can improve the efficiency of care and streamline care work, thus helping to alleviate the challenge above. These investments include the creation of new care services by adopting innovations such as social robots, and the update of existing care services by replacing analogue technologies with digital versions, such as social alarm systems. While numerous studies have discussed the implementation of new digital technologies, the digitalization of existing care services has received less attention.This dissertation conducts empirical investigations on the digitalization of social alarm systems in four Swedish nursing homes. By applying theories of social shaping of technology with a focus on socio-technical transformations in care practices, it asks how implementation of the new social alarm systems is socially shaped in care practices. The social alarm system is an established technology that aims to enable users to call for help in emergencies. Based on a literature review of the central theme (Paper I), the dissertation examines discrepancies between planned and actual implementation outcomes (Paper II), differences within a team during project executing (Paper III), and the relationship between individuals’ actual use of technology and the assumptions inscribed in the system and the diverse care concepts in nursing homes (Paper IV). The methodological basis of the dissertation comprises analysis of implementation documents, observations of healthcare professionals’ daily work, interviews with employees of both technology companies and nursing homes, questionnaires completed by healthcare professionals, and a literature review.The results reveal that technology implementation is far from predictable outside the care context. During the implementation process, people from different groups have distinct goals, focus on different facets, and develop diverse approaches for integrating the system into daily work. Frontline professionals determine their ways of using the new social alarm system based on their personal and situational understanding of technology scripts and care concepts under given contexts. The results contribute to theoretical clarifications as well as practical possibilities and limitations to guide the implementation of social alarm systems in nursing homes. The findings indicate that the introduction of a digital social alarm system brings various changes. The digitalization of social alarm services in nursing homes can benefit from a clear positioning of the new system, a common ground for sufficient communication between actors involved, and an in-depth interpretation of local environments, as well as flexible and continuous implementation strategies.