Dissertation Information for Elizabeth YakelNAME:
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SCHOOL: ADVISORS: COMMITTEE MEMBERS: MPACT Status: Fully Complete Title: Recordkeeping in radiology: The relationships between activities and records in radiological processes Abstract: Recordkeeping is ubiquitous in organizations. However, our understanding of the role recordkeeping plays is far from complete. This dissertation analyzed the development of recordkeeping systems and the creation and use of records in the context of a radiology department in a major medical center. The research examined recordkeeping through the archival principle of provenance which was defined as the relationships between activities and records. The dissertation argued for the primacy of process and followed the development and use of recordkeeping systems and records within two central processes in radiology: (1) image interpretation/dictation and (2) consultations between radiologists and clinicians. Principal research questions concerned the ways in which recordkeeping was embedded in larger organizational processes and how recordkeeping supported or failed to support these processes. The data collected was comprised of videotaped activities in radiological reading rooms, interviews with radiologists and clinicians, and archival data. Analyses included a thick ethnographic description, content analysis, and conversation analysis. In total, 138 instances of radiological interpretation and report dictation and 158 consultations between radiologists and clinicians were observed and analyzed. Results indicated that the form and content of radiological reports were influenced by administrative, professional, as well as local radiological practices aimed at fostering different types of organizational accountability and efficiency. Sometime, radiological reports failed to satisfy clinicians' questions and consultations ensued. Although consultations were invisible activities in that they were rarely noted in official records, many consultations relied heavily on both official and unofficial recordkeeping systems to sustain "heedful interrelating" among diverse medical professionals and to maintain organizational memory and learning in the medical center. It was also found that there were distinct differences between the radiological specialties of ultrasound imaging and chest radiography in information sources and records consulted during both radiological interpretation and dictation and during consultations. Finally, the importance of these findings for the design of teleradiology systems was noted. |
MPACT Scores for Elizabeth YakelA = 3 Advisors and Advisees Graph |