Fragmented care trajectories in municipal healthcare: Local sensemaking of digital documentation

Bidragets oversatte titel: Fragmenterede borgerforløb i kommunal pleje og omsorg-lokal meningsdannelse om digital dokumentation

Julie Duval Jensen*, Loni Kraus Ledderer, Raymond Kolbæk, Kirsten Beedholm

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review


Objective: Since the 1990s, almost all healthcare organisations have had electronic health records (EHR) to organise and
manage treatment, care and work routines. This article aims to understand how healthcare professionals (HCPs) make
sense of digital documentation practice.
Methods: Based on a case study design, field observations and semi-structured interviews were conducted in a Danish
municipality. A systematic analysis based on Karl Weick’s sensemaking theory was applied to investigate what cues HCPs
extract from timetables in the EHR and how institutional logics frame the enactment of documentation practice.
Results: The analysis uncovered three themes: making sense of planning, making sense of tasks and making sense of documentation. The themes illustrate that HCPs make sense of the digital documentation practice as a dominant managerial tool
designed to control resources and work routines. This sensemaking leads to a task-oriented practice which centres on delivering fragmented tasks according to a timetable.
Conclusion: HCPs mitigate fragmentation by responding to a care professional logic, where they document to share information and carry out invisible work outside of timetables and scheduled tasks. However, HCPs are focused on solving specific tasks by the minute with the possible consequence that continuity and their overview of the service user’s care and
treatment disappear. In conclusion, the EHR system eliminates a holistic view of care trajectories, leaving it up to HCPs
to collaborate in an effort to obtain continuity for the service user.
Bidragets oversatte titelFragmenterede borgerforløb i kommunal pleje og omsorg-lokal meningsdannelse om digital dokumentation
TidsskriftDigital Health
StatusUdgivet - jun. 2023


  • Digitalisering
  • Dokumentation
  • Journalføring
  • kommunal ældrepleje
  • sygepleje