Documents in Place: Demarcating Places for Collaboration in Healthcare Settings

The notion of place often connotes our understood reality populated with people, practices, meanings, and artifacts. This paper suggests that documents, whether electronic, paper-based, or set in stone, offer important insights into how people establish and maintain places for communication and coordination. Data from an ethnographic study in a large hospital system illustrates how doctors carefully craft their medical histories in various electronic record systems to demarcate specific places for their communication and coordination with specific collaborators. Such documents serve as portable places, allowing the doctors to navigate a constantly changing landscape of relevant patients, participants, times, and spaces. The documents demarcate such places by pointing out the interdependencies among particular participants, places, and times. Doctors care deeply about these documents and they play a central part not only in securing efficient communication and coordination but also in the socialization of newcomers. A study of the complex interrelationships between documents and place, therefore, offers important insights into organizational environments characterized by distributed and mobile work practices.