Care with assistive technologies: professional responsibility when learning to navigate the unforeseen in homecare services

What is it about?

This study explores how responsibility is managed by an interprofessional team of healthcare professionals when unforeseen challenges in the use of assistive technologies in homecare raise care concerns for specific users. An ethnographic approach was used to study the daily work of integrating assistive technologies into homecare services. By observing 27 interprofessional team meetings, we investigated how challenges in using these technologies for specific cases were handled collectively. A sociomaterial perspective and practice theory were used to analyze relevant actors—those being “individuals or collectives,” “material actors,” “events and risks,” and “concepts and directives for care”—displayed as healthcare professionals discussed their concerns, and how responsibilities were reconsidered in ongoing patient care. We found that unforeseen challenges put the professional responsibility of the healthcare team at stake in knowing how to respond. They collectively managed distributed responsibilities by (1) reviewing user cases’ uncertainties and vulnerabilities, (2) reviewing concern specific relationalities, and (3) reconsidering responsibilities and approaches to how care should be given. In this process health professionals either assumed, delineated, delegated, or reassumed responsibility for specific care needs. We claim that this "responsibility work" and the care for relationalities it entails contribute to the stabilization of homecare service practices by embedding the use of technology in the changing health needs of users. This article contributes to the field by proposing responsibility work as a constitutive part of practitioners’ knowing and learning at work in complex organizations under digital transformation. In such work, the complexities stemming from the involvement of different actors, relations, and emerging concerns are collaboratively managed as matters of care through professional discussions in situated workplace practices.

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