Adopting a logistics robot system in a central hospital: Perspectives of different internal stakeholders

Robotics as well as other new technologies provide opportunities for ensuring good quality public services for citizens, despite the financial and demographic challenges in Finland and other Western countries today. Implementation of robots in the social and welfare sector induces changes both at the individual and organizational levels as well as in the whole society. This kind of development calls for new innovations - both technological and organizational. The ROSE project "Robots and the Future of Welfare Services", funded by Academy of Finland Strategic Research Council, was launched in autumn 2015 to tackle these questions in a multidisciplinary way. Our specific research interest is to clarify how adoption of robots will change care work and the ways it is organized and managed, and how these perspectives should be taken into account when such systems are acquired and taken into use. Very little scientific publications still exist on this topic, and the fact that practical implementation of robots in the actual care work is still scarce makes studying the topic challenging. We aim at learning as much as possible from related cases. Here we present a case study of how a logistics robot system is being taken into use in a large Finnish hospital. The final system comprises of eight similar autonomous mobile robots performing delivery and transportation tasks. The first two robots have been in use since October 2016. One robot transports instruments between an instrument maintenance unit and three operational units, including the surgery outpatient department. Another one transports items from the hospital's central storage to selected units. The transports to the surgery outpatient department started in January 2017. Three more robots will arrive this year and the last three in 2018. Possible functional extension areas are transport of laundry, waste, food and medicaments. From the few recent studies concerning adoption of robotics in health care, we have learned that the expected benefits of the innovation are jeopardized if the purchased technology is not integrated into change in work practice in a purposeful manner (e.g. Mutlu & Forlizzi, 2008; Beane & Orlikowski, 2015). For a successful adoption of innovations it is of crucial importance that the relevant stakeholders are engaged in the process (e.g. Kallio 2015; Boman et al. 2014). These observations make the main focus of inquiry in our case study. We have interviewed six persons working in different roles in the hospital: the logistics manager being responsible for the robot acquisition project; the head of the material department; a director of the support service unit; the head of instrument maintenance unit; the head nurse of surgery outpatient department; and a worker at central storage. Although the number of the interviewees is quite small our data helps getting a multiperspective picture on the case. We have also briefly observed the early adoption phase of the robots. Here we present our initial findings. The acquisition process, which deals from the hospital's point of view with a "middle" size investment, seems to have been initiated quite spontaneously but conducted then in a very systematic manner. At this point most of the "children deceases" seem to be overcome. Savings in personnel costs related to internal transports are expected which naturally evokes concerns. Otherwise the personnel's and public's reactions have been quite positive. The logistics robots should affect the actual care work in a rather limited way. As the robots enable 24/7 transportation the disturbances of internal transport traffic to the personnel has reduced. Some positive effects on the work flow have also been identified: e.g. more daily transports enable better availability of instruments. Interestingly, the perceptions of the two interviewed nurses differ markedly concerning their possibility to participate in the early phases of the implementation process. More engament would have been desirable from the instrument maintenance unit's view point. This reflects the different activities of the respective units: reliability of the instrument transports is directly related to the core task of the instrument maintenance unit. In the conference presentation, we will describe our findings in more detail. So far the results seem to support the existing studies on the importance of stakeholder involvement starting from the very early phases of innovation processes (e.g. Kallio 2015; Boman et al., 2014; Kivisaari et al. 2013). Our study narrows the identified research gap by adopting the systemic approach to the robotics in care work to increase understanding them as complex socio-technical systems and the related change dynamics among relevant stakeholders (cf. Mutlu & Forlizzi, 2008).