Organisational culture and information systems implementation : a critical perspective
This research explores how information systems (IS) implementation is accomplished when cultural change of an organisation is attempted and what this accomplishment means for those touched by it. Efforts of this kind are being made in the UK National Health Service (NHS), Where modernisation programmes involving technological rationalisation and change are aiming to make the NHS more responsive to contemporary public demands. This study focuses on the ambulance services and specifically on a history of IS implementation efforts over 20 year at the largest and most appraised of the English services, the London Ambulance Service (LAS). A perceived need for cultural change involving the use of advanced information technologies is pervasive in managerial and ministerial discourses about modernising the health service. Yet the way that ambulance services are regulated and monitored has given rise to a modernisation programme in which cultural change and IS implementation have been conceived largely instrumentally in terms of achieving performance targets. Moreover, goals to which the modernisation efforts aspire are at most partially realised. Organisational change is uneven, and the performance improvements achieved are contradictory, and this is not only true in London but elsewhere in the UK. Drawing from organisational theory and critical social theory, past IS implementation efforts at the LAS are reinterpreted in light of recent developments, with contributions to theory and practice in mind. The theoretical contribution rests in exploring how emotion as well as rationality may be conceptualised to examine historically and culturally constituted working practices. Implications for practice address how IS implementation can give rise to cultural fragmentation, and also how professional identity can constrain IS innovation. Finally, the research contributes to a current debate about the future for ambulance services and the mechanisms used to evaluate their performance.