Computerised hospital work: Fordism and Faylorism revisited

Abstract This paper explores the way in which a computerised workload system, Excelcare, rationalises nursing care. Excelcare enables management to track, control, time and cost nursing work – a task I will argue is increasingly necessary under Casemix funding. Using a case study approach I argue that Excelcare provides management with refined opportunities to further rationalise production systems through creating records of ‘virtual work time’ as opposed to real working time. The ambiguity surrounding the purpose of Excelcare, ensures worker compliance and provides management with data for further lean production work arrangements. It also illustrates the way in which time is used in the bureaucratic search for both equity and control.