Abstract
The overall purpose in this research has been to investigate what happens when somebody or something intervenes in a knowledge worker´s every-day life. Empirically, the author has chosen to explore how an anesthesia patient record is constructed to be what it becomes and then computerized and the implications of this for the anesthesist and the anesthesia nurse. The research takes place among a group of people that call themselves emergency people. Some of them think that the art of the performance will be at risk if the anesthesia patient record is computerized. The author has used a theoretical framework integrating ideas about knowledge management with concepts from structuration theory and theories about sensemaking, representations and schema use. Integrating knowledge management with structuration theory makes it possible to capture the complexity of what takes place when a knowledge worker shuttles between transformation and routine in an organizational setting in the knowledge society. “The clinical eye” emerges as a concept that influences how an anesthesist searches for information, how knowledge is exercised in anesthesia and how a patient record should be designed. The author concludes that the clinical eye is a central concept for understanding how an anesthesist exercises his or her knowledge, how the content of a patient record is constructed and designed and how reactions to a changed evolve. The author introduces two concepts “knowledge structuring” and “knowledge domination” that are considered important and interrelated. Exercising knowledge is a structured activity. In our heads we make plans for what to do, how to do it and what to do next. When an organizational setting is structured the knowledge that is exercised in this setting also becomes structured. An anesthesist exercises the practice of anesthesia in a structured order in a certain space during a certain time-period. When upgrading and computerizing the anesthesia patient record, both a transformation and an additional structuring of how knowledge is exercised take place. The question then becomes how this new structuring influences the practice of performing anesthesia. In addition to this the author theorizes that if the computerized patient record is conceptualized as a knowledge management system the way it is used changes. Many more services are included, and it is not “just” a patient record anymore.