Constructing safety: System designs, system effects, and the play of heterogeneous interests in a behavioral health care setting

Abstract

Objective This paper considers the utility of actor-network theory as a basis for uncovering the mutual interdependencies between system design and system impact in an evolving project, and for exploring the implications that these interdependencies hold for the production of safety in behavioral health care. Methods Drawing on a field study of a systems project in a human-services firm, the paper applies key concepts from actor-network theory in the analysis of a design crisis that emerged during the course of the project. Results Actor-network theory provides a compelling framework in this situation for identifying the diverse interests involved, revealing their complex interactions, and illuminating the importance of the emerging system as an organizational actor in its own right. Conclusion Actor-network theory shows promise for use in other analyses concerned with the role of information technology in the construction of safety in health care settings.