Year

2008

Degree Name

Doctor of Philosophy

Department

Faculty of Commerce

Abstract

Information and communications technologies (ICT), together with the growth of the World-Wide Web, have brought about immense changes that provide new opportunities for processing information and supporting communication. These opportunities can be exploited through innovative information systems in important areas such as the one addressed in this thesis, namely, the use of web-sites to link expert professionals with the general public. The particular focus of the research reported here is the field of health, where medical outcomes can be improved by various modes of information exchanges between healthcare professionals and the public.

The research approach taken in this thesis acknowledges the complexity of the situation in an ICU and the interrelationship of constantly changing organisational, human and technical elements in a stressful context. In addition to information from the literature, data is collected and analysed from three sets of ICU stakeholders (clinicians, families of patients, State Health Department website owners) using three different techniques suited to the context of the stakeholders. The results of this analysis feed into an evolutionary System Dynamics modelling process, which both integrates the data and literature, and also dynamically visualises the information flows between the different stakeholders. The resulting model is then qualitatively reinterpreted using concepts and frameworks from Activity Theory in order to provide deeper insights into the relationships within the system.

The final stage of the research uses Activity Theory to further explore the relationships between people, tools, processes and elements of the ICU environment. Activity Theory is concerned with explaining and analysing human activity with a rich holistic understanding of how people collaborate with the assistance of sophisticated tools in the complex dynamic environments of modern organisations.

Findings from the data analysis supported the on-going evolutionary development of a SD model using the stock and flow techniques of Stella software. System Dynamics modelling is a general technique used to imitate, on computers, systems exhibiting complex, time-dependent behaviour. In this case, a model was created to present the information flows and accumulation of understanding during critical situations of patient care in the ICU. Models can be used to investigate the system without disrupting the real activity; a very important issue in the work of an ICU. It is possible to replicate complex patterns of behaviour and gain insight about the interaction of variables in a dynamic and holistic way that is not achievable in the traditional reductions and objective approaches to research.

This study makes significant theoretical and practical contributions regarding online professional-public communication and web-based information services. This study highlights the importance of online information services for experts to communicate with the public, particularly in advanced countries like Australia. The findings, however, show that it is difficult to do this well and that initial attempts may not meet the needs of intended users and hence not be well used.

The practical research contribution is significant in that it provides a method for improving Health Care Web-Based Information delivery in Intensive Care Environments.

In future research, the approach and results of this study could be used to examine issues concerned with the use of the Web for information flows, knowledge transfer, understanding and learning in different types of crisis situations that cannot easily be studied by conventional research methods.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.