Barcode medication administration: supporting transitions in articulation work

Articulation work is that which enables coordinated activity among colleagues distributed in time and space. Despite its important role in clinical settings, this work remains largely invisible in process flowcharts. When process-oriented information systems are implemented, the informal, flexible, contingent activities of participants that enable coordinated work are suddenly placed in a new context. Articulation work must adapt to new contexts of automation, and there are opportunities for clinical systems to better support coordination activities. This research explores the articulation work involved in medication administration, how it is affected by the implementation of barcoding, and strategies for support and problem resolution in this arena.