Thin Spindles, Fat Cows, Ludwig Wittgenstein, & the Utility of

Sociology Pennsylvania Sociological Society

October, 2007

Ross Koppel, Ph.D.Ross Koppel, Ph.D. Sociology Department & Sociology Department &

Center for Clinical Epidemiology & BiostatisticsCenter for Clinical Epidemiology & BiostatisticsSchool of Medicine, University of PennsylvaniaSchool of Medicine, University of Pennsylvania

rkoppel@sas.upenn.edurkoppel@sas.upenn.edu

Auguste

Karl

Max

Emile

William Foote Whyte

Ludwig Wittgenstein'The aspects of things

that are most important for us are hidden because of their simplicity and familiarity'. (1968, para 129)

David Silverman

“Strangely, what we are concerned with in qualitative social science is what is closest to hand. However, because it is so close to hand, both participants and researchers may often forget about it..”

JUST SAY NO: An Anti Rape Strategy

Analyzed by Hannah Frith and Celia Kitzinger (1998)….reported by David Silverman.

Dealing with unwanted sex:

From focus group:

“Carla”: I try to think of a way to turn him down without hurting his feelings ... Next time I do see him, in a way I make a special effort to talk to him to show that there are no hard feelings

Emotional Talk Work is Real Work Silverman writes: “The implication of this

research is to recognise that people are active subjects who are not simply puppets of cultural codes. …that well-meaning rape-resistance strategies, such as the ‘just say no’ campaign may overlook how people actually converse. …‘saying no,’ is a ‘dispreferred’ activity requiring considerable interactional work.”

Many Ethnographers for Policy

Just from University of Pennsylvania Elijah Anderson Kathy Edin Charles Bosk Erving Goffman

Head Start & The Power of Sociology

The Power of Sociology Even when wrong…or not right

Head Start

The Power of Sociology Even when it took a while to be right

Head Start

MBTA….The “T”

Sampling Parameters

Studied actual BCMA use at 5 hospitals:

1-Shadowing of nurses;

2-Analyses of 320,000 medication- and patient-ID BCMA uses… and 36,000 alert-override reasons;

What we did (b)3-Interviews with physicians,

nurses, pharmacists, IT-directors, vendors, and 34 hospital leaders;

4-Participation in BCMA-use reviews and failure-mode-and-effects analyses

5-Participation at M&M reviews

Results 1: Fifteen identified workarounds (a) (Extra Copies)

1 example: Reproducing patients’ wristband ID-barcodes, & affixing them to nursing station, computer cart, supply room, pt’s room doorjamb, medication dispensing machine…

Results 1: Fifteen identified workarounds (b)

1 example, continued--Barcode affixed to: RN clipboard, scanner itself,

in nurses’ pockets or on

belt-rings, or worn as a

group of bangles on

nurse’s sleeve.

Results 2: 31causes of workarounds (a)

E.g., unreadable medication barcodes (crinkled, smudged, torn, missing, covered by another label);

Do not forget to scan barcode

Results 2: 31causes of workarounds (b)

E.g., (continued) malfunctioning scanners; unreadable or missing patient-ID-wristbands (chewed, soaked, missing); un-barcoded-medications; failing batteries and wireless connectivity; contact isolation; emergencies

Simple Interfaces for Machines

Computer on Wheels (COW)

Barcode scanner

with computer

Fat COW

Another example: This from work on Computerized Physician Order Entry…Very stupid programming…found by sociologist

5

4

1

7

3

2

Sociology to Find Problems

Manifest: Programming

Real: Power Money Autonomy Markets Division of Labor

Sociology to Find ProblemsSociology to Solve Problems

In Short…. The use of Sociology

Sociology to Find ProblemsSociology to Solve Problems

“On the shoulders of giants…”Reintroduced by

Robert Merton

What other profession?

What other profession?

Thank you (and Sociology)!Ross Koppel Univ. of Pennsylvania rkoppel@sas.upenn.edu