Thin Spindles Fat Cows Ludwig Wittgenstein the Utility

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Thin Spindles, Fat Cows, Ludwig Wittgenstein, & the Utility of Sociology Pennsylvania Sociological Society

Thin Spindles, Fat Cows, Ludwig Wittgenstein, & the Utility of Sociology Pennsylvania Sociological Society October, 2007 Ross Koppel, Ph. D. Sociology Department & Center for Clinical Epidemiology & Biostatistics School of Medicine, University of Pennsylvania rkoppel@sas. upenn. edu

Auguste

Auguste

Karl

Karl

Max

Max

Emile

Emile

William Foote Whyte

William Foote Whyte

Ludwig Wittgenstein 'The aspects of things that are most important for us are hidden

Ludwig Wittgenstein 'The aspects of things that are most important for us are hidden because of their simplicity and familiarity'. (1968, para 129)

David Silverman “Strangely, what we are concerned with in qualitative social science is what

David Silverman “Strangely, what we are concerned with in qualitative social science is what is closest to hand. However, because it is so close to hand, both participants and researchers may often forget about it. . ”

JUST SAY NO: An Anti Rape Strategy n Analyzed by Hannah Frith and Celia

JUST SAY NO: An Anti Rape Strategy n Analyzed by Hannah Frith and Celia Kitzinger (1998)…. reported by David Silverman.

Dealing with unwanted sex: From focus group: “Carla”: I try to think of a

Dealing with unwanted sex: From focus group: “Carla”: I try to think of a way to turn him down without hurting his feelings. . . Next time I do see him, in a way I make a special effort to talk to him to show that there are no hard feelings

Emotional Talk Work is Real Work n Silverman writes: “The implication of this research

Emotional Talk Work is Real Work n Silverman writes: “The implication of this research is to recognise that people are active subjects who are not simply puppets of cultural codes. …that wellmeaning rape-resistance strategies, such as the ‘just say no’ campaign may overlook how people actually converse. …‘saying no, ’ is a ‘dispreferred’ activity requiring considerable interactional work. ”

Many Ethnographers for Policy Just from University of Pennsylvania n Elijah Anderson n Kathy

Many Ethnographers for Policy Just from University of Pennsylvania n Elijah Anderson n Kathy Edin n Charles Bosk n Erving Goffman

Head Start & The Power of Sociology

Head Start & The Power of Sociology

The Power of Sociology n Even when wrong…or not right Head Start

The Power of Sociology n Even when wrong…or not right Head Start

The Power of Sociology n Even when it took a while to be right

The Power of Sociology n Even when it took a while to be right Head Start

MBTA…. The “T”

MBTA…. The “T”

Sampling Parameters

Sampling Parameters

Studied actual BCMA use at 5 hospitals: 1 -Shadowing of nurses; 2 -Analyses of

Studied actual BCMA use at 5 hospitals: 1 -Shadowing of nurses; 2 -Analyses of 320, 000 medication- and patient-ID BCMA uses… and 36, 000 alert-override reasons;

What we did (b)physicians, 3 -Interviews with nurses, pharmacists, ITdirectors, vendors, and 34 hospital

What we did (b)physicians, 3 -Interviews with nurses, pharmacists, ITdirectors, vendors, and 34 hospital leaders; 4 -Participation in BCMA-use reviews and failure-modeand-effects analyses 5 -Participation at M&M reviews

Results 1: Fifteen identified workarounds (a) (Extra Copies) 1 example: Reproducing patients’ wristband IDbarcodes,

Results 1: Fifteen identified workarounds (a) (Extra Copies) 1 example: Reproducing patients’ wristband IDbarcodes, & affixing them to nursing station, computer cart, supply room, pt’s room doorjamb, medication dispensing machine…

Results 1: Fifteen identified workarounds (b) 1 example, continued--Barcode affixed to: RN clipboard, scanner

Results 1: Fifteen identified workarounds (b) 1 example, continued--Barcode affixed to: RN clipboard, scanner itself, in nurses’ pockets or on belt-rings, or worn as a group of bangles on nurse’s sleeve.

Results 2: 31 causes of workarounds (a) n E. g. , unreadable medication barcodes

Results 2: 31 causes of workarounds (a) n E. g. , unreadable medication barcodes (crinkled, smudged, torn, missing, covered by another label); Do not forget to scan barcode

Results 2: 31 causes of workarounds (b) n E. g. , (continued) malfunctioning scanners;

Results 2: 31 causes of workarounds (b) n E. g. , (continued) malfunctioning scanners; unreadable or missing patient-IDwristbands (chewed, soaked, missing); unbarcoded-medications; failing batteries and wireless connectivity; contact isolation; emergencies

Simple Interfaces for Machines

Simple Interfaces for Machines

Computer on Wheels (COW) Barcode scanner with computer n

Computer on Wheels (COW) Barcode scanner with computer n

Fat COW

Fat COW

Another example: This from work on Computerized Physician Order Entry…Very stupid programming…found by sociologist

Another example: This from work on Computerized Physician Order Entry…Very stupid programming…found by sociologist 5 4 1 7 3 2

Sociology to Find Problems Manifest: Programming Real: n Power n Money n Autonomy n

Sociology to Find Problems Manifest: Programming Real: n Power n Money n Autonomy n Markets n Division of Labor

Sociology to Find Problems Sociology to Solve Problems In Short…. The use of Sociology

Sociology to Find Problems Sociology to Solve Problems In Short…. The use of Sociology

Sociology to Find Problems Sociology to Solve Problems “On the shoulders of giants…” Reintroduced

Sociology to Find Problems Sociology to Solve Problems “On the shoulders of giants…” Reintroduced by Robert Merton

What other profession?

What other profession?

What other profession?

What other profession?

Thank you (and Sociology)! Ross Koppel Univ. of Pennsylvania rkoppel@sas. upenn. edu

Thank you (and Sociology)! Ross Koppel Univ. of Pennsylvania rkoppel@sas. upenn. edu