Thin Spindles, Fat Cows, Ludwig Wittgenstein, & the Utility of Sociology Pennsylvania Sociological Society October,

1. Thin Spindles, Fat Cows, Ludwig Wittgenstein, & the Utility of SociologyPennsylvania Sociological Society October, 2007 Ross Koppel, Ph.D. Sociology Department & Center for Clinical Epidemiology & Biostatistics School of Medicine, University of Pennsylvania rkoppel@sas.upenn.edu

2. Auguste

3. Karl

4. Max

5. Emile

6. William Foote Whyte

10. 'The aspects of things that are most important for us are hidden because of their simplicity and familiarity'. (1968, para 129) Ludwig Wittgenstein

11. 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..”

12. JUST SAY NO: An Anti Rape Strategy • Analyzed by Hannah Frith and Celia Kitzinger (1998)….reported by David Silverman.

13. 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

14. 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.”

15. Many Ethnographers for Policy Just from University of Pennsylvania • Elijah Anderson • Kathy Edin • Charles Bosk • Erving Goffman

16. Head Start & The Power of Sociology

17. The Power of Sociology • Even when wrong…or not right Head Start

18. The Power of Sociology • Even when it took a while to be right Head Start

19. MBTA….The “T”

24. Sampling Parameters

28. 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;

29. 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

30. 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…

31. 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.

32. 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

33. 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

34. Simple Interfaces for Machines

35. Computer on Wheels (COW) • Barcode scanner with computer

36. Fat COW

37. Another example: This from work on Computerized Physician Order Entry…Very stupid programming…found by sociologist 5 4 1 7 3 2

38. Sociology to Find Problems Manifest: Programming Real: • Power • Money • Autonomy • Markets • Division of Labor

39. Sociology to Find Problems Sociology to Solve Problems In Short…. The use of Sociology

40. Sociology to Find Problems Sociology to Solve Problems “On the shoulders of giants…” Reintroduced by Robert Merton

41. What other profession?

42. What other profession?

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