Accounting for the Invisible Work of Hospital Orderlies: Designing for Local and Global Coordination

The cooperative, invisible non-clinical work of hospital orderlies is often overlooked. It consists foremost of transferring patients between hospital departments. As the overall efficiency of the hospital is highly dependent on the coordination of the work of orderlies, this study investigates the coordination changes in orderlies’ work practices in connection to the implementation of a workflow application at the hospital. By applying a mixed methods approach (both qualitative and quantitative studies), this paper calls for attention to the changes in orderlies’ coordination activities while moving from a manual and centralized form to a semi-automatic and decentralized approach after the introduction of the workflow application. We highlight a set of cross-boundary (spatial and organizational) information sharing breakdowns and the challenges of orderlies in maintaining local and global coordination. We also present design recommendations for future design of coordination tools to support orderlies’ work practices.