Disruptive Technologies in Systems of Care: An Exploratory Study of Culture Change in Long-Term Care

Background and Purpose: The purpose of this exploratory research was threefold, first to demonstrate that the Eden Alternative™ would serve as a good example of a disruptive soft technology. Second, that Eden Alternative™ would link to the theoretical literature on culture and structuration theory where it would highlight the internal struggle of culture to resist or relent to change and how structures would reform in the new culture after disruptive technology is introduced. In doing so the researcher sought to replicate previous studies (Barley 1984; Black et al. 2004) which investigated the introduction of CAT scan technology in the radiology departments at two different hospitals. The hypothesis being that it was not the technology that leads to different outcomes, but the social interaction with the technology. Third to determine the extent to which social workers are or become viewed as experts in the Eden Alternative as a soft technology and what role social workers have in implementing Eden Alternative in long-term care facilities.

Methods: Observations were conducted in two long-term care facilities implementing the Eden Alternative™concurrently. Sampling was achieved purposively where facilities fitting the study criteria were invited to participate and from those showing and interest, two were selected. The researcher conducted observations over 10 to 12 months to see how the organizational cultures responded to the changes the facilities were being asked to make and look at the differences in implementation. Data was analyzed by conducting thematic coding that was driven by the theoretical nature of the investigation. Special attention was paid to use of authority, power, collaboration and cooperation among indicators of how implementation was proceeding. The researcher also administered a brief survey to the staff to determine if their self-report would corroborate the observations in the field.

Results: This research has learned that Eden Alternative™ did behave as a disruptive soft technology disrupting the existing culture of both settings into which it was introduced during the observation period. Each facility confronted unique contextual challenges to implementing Eden Alternative™ and these challenges exerted influence on how the implementation proceeded and the reformation of culture once implementation was completed. Finally, results indicated that social services staff were not viewed as experts in this soft technology; and indeed that these positions were not held by trained, credentialed social workers.

Conclusions and Implications: The results, while not identical to those seen earlier (Barley 1984, 1986; Black, Carlile and Repenning, 2004) reveal the ways in which the behaviors in relationship to the technology are similar to what these previous researchers found. The findings support the previous research (Barley, 1984, 1986; Black et al, 2004) indicating that soft technologies are disruptive to the organizational culture when they are introduced. These disruptions should be accounted for when planning organizational change and should be managed by professionals with knowledge of social systems. In the end this research sounds a call to leadership for social work in the long-term care industry and to educators to prepare social workers for leadership in this context.