Dakin Francesca H, Hemmings Nina, Kalin Asli, Moore Lucy, Ladds Emma, Payne Rebecca, Rosen Rebecca, Byng Richard, Wherton Joseph, Wieringa Sietse, Greenhalgh Trisha
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Nuffield Trust, London.
Br J Gen Pract. 2025 Feb 27;75(752):e211-e221. doi: 10.3399/BJGP.2024.0322. Print 2025 Mar.
The introduction of remote and digital forms of working in UK general practice has driven the development of new routines and working styles.
To explore and theorise how new forms of work have affected general practice staff.
Multi-sited, qualitative case study in UK general practice.
Using longitudinal ethnography by researchers in residence, we followed 12 practices for 28 months (September 2021 to December 2023). This core dataset was supplemented by workshops and stakeholder interviews. Data analysis applied theories from the sociology of work, organisation studies, and internet studies.
Staff made significant efforts to adapt to and embed digital services into their work. When technologies work well they can offer improved convenience, efficiency, more comprehensive patient care, and workplace fulfilment for staff. However, for many clinical and administrative staff, compromises and frictions embedded in digitalised workplace routines and processes could also lead to job dissatisfaction, worsened wellbeing, and misalignments with professional values and identities. We found that this workplace suffering caused relational strain between team members and had an impact on team cohesiveness and coordination.
The digitalisation of working routines in UK general practice poses a unique challenge to the workforce, risking technostress, workplace suffering, and increased relational strain within and between teams. To embed the benefits of digitalisation, we must first improve practice teams' readiness for change, which includes strengthening practices' relational structures that provide support during periods of adaptation. Practices must be empowered to determine a locally appropriate configuration of digital tools and given the resources and time to adapt working routines.
英国全科医疗中远程和数字化工作形式的引入推动了新工作惯例和工作方式的发展。
探讨并从理论上分析新的工作形式如何影响全科医疗工作人员。
英国全科医疗的多地点定性案例研究。
研究人员采用驻点纵向人种志研究方法，对12家医疗机构进行了为期28个月（2021年9月至2023年12月）的跟踪研究。该核心数据集通过研讨会和利益相关者访谈进行补充。数据分析应用了工作社会学、组织研究和互联网研究的理论。
工作人员为适应数字化服务并将其融入工作付出了巨大努力。当技术运行良好时，它们可以提供更高的便利性、效率、更全面的患者护理以及员工的工作满意度。然而，对于许多临床和行政人员来说，数字化工作场所惯例和流程中存在的妥协和摩擦也可能导致工作不满、幸福感下降以及与职业价值观和身份的不一致。我们发现，这种工作场所的痛苦会导致团队成员之间的关系紧张，并对团队凝聚力和协作产生影响。
英国全科医疗工作流程的数字化给劳动力带来了独特的挑战，存在技术压力、工作场所痛苦以及团队内部和团队之间关系紧张加剧的风险。为了充分发挥数字化的优势，我们必须首先提高医疗机构团队对变革的准备程度，这包括加强医疗机构的关系结构，以便在适应期提供支持。必须赋予医疗机构权力，以确定适合当地的数字工具配置，并给予其调整工作流程所需的资源和时间。
