Formalization and Accountability in Surgery Planning

Due to poor resource utilization in surgery performance, there is increasing interest in applying workflow systems. Notably, due to their ability to "steer" the execution of the process toward an intended goal, according to an arrangement of things, data and resources compliant with "best practice", the systems are supposed to improve surgery planning and, hence, resource utilization. This study reports from a large-scale Electronic Patient Record development project, which also included workflow support in a surgery planning module. By applying an understanding of workflow systems and their ordering and coordinative mechanisms, this study investigates the effect of such systems on interdisciplinary work in surgery planning. The study shows that interdisciplinary work is affected by workflow systems in the way that the systems "order" responsibility and sequential dependency of tasks. The collective responsibility was affected by the sequential ordering and user role constraints inherent to the system. Moreover, there was a clear redistribution of tasks as a consequence of the formalization and the accountability mechanism.