Welfare Technology – You Need to do it Right! A Qualitative Study of the Work of Care Workers to Provide Patient Safety at Home through Technology.

Abstract Background In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Welfare technology is one of the fastest-growing technology-domains in western health care systems. In the marketing of welfare technology, the expectation is that safety is provided simply by being present in patients’ homes. Whilst both research and health authorities are concerned with developing cost-benefit analysis and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies deliver patient safety. This paper aims to describe how patient safety in home care is performed through and with welfare technology. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. MethodsWe draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. Building on a qualitative explorative design, we analyse observations of practice and interviews with the actors involved, in accordance with King's outline of template analysis.ResultsOur analysis illuminated three co-existing work processes where patient safety is secured: “Aligning people and technologies”; “Being alert and staying calm”; and “Coordinating activities depending on people and technology”. Attention to these work processes exposes the detailed practices of safety, and how it is produced in relational practices involving multiple people and technologies.ConclusionsWe conclude that the three work processes identified are essential if the safety alarm is to function for the end-user’s safety. Home-dwelling patients' safety is reliant on the people involved with technologies, and technologies do not create this on their own. The efforts of care workers are a central feature of creating safety in a patient's home, and in doing so, they utilise a repertoire of skills and knowledge.