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Updated: May 15, 2026

RBDT: A Computerized Task System based in Transposition for the Continuous Analysis of Relational Behavior Dynamics in Humans
Published on: July 17, 2021
Finding hidden sources of new work from BCMA implementation: the value of an organizational routines perspective
1Implementation Sciences Laboratory, Vanderbilt University School of Medicine, Nashville, TN, USA.
Abstract:
It is acknowledged that there is a difference between abstract representations of clinical work and work as it is performed in context. In this qualitative study of the implementation of barcode medication administration (BCMA), hidden work resulting from the implementation of BCMA is described. Organizational routines theory provides the framework for examining the dynamics of key organizational practices. The study documents new cognitive and physical tasks that were required of nurses when BCMA was implemented. Because many of these tasks were not part of the commonly understood workflow of the BCMA system and because they were obscured in problematic interactions between organizational routines, they are characterized as "hidden work". Categories of hidden work are described and the implications for implementation research and practice are discussed.
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