Information system design, stress and organisational change in the ambulance services: A tale of two cities

The development of information systems (IS) is a problematic process that all too often ends in failure. This paper reports a comparative analysis of two projects involving the computerisation of ambulance control-room operations in London and Manchester. The outcomes were strikingly different. In the London case, severe operational problems led to the abandonment of the project. In contrast, we report an intensive psychophysiological evaluation of the Manchester project showing that the new system led to both improved service levels and reduced stress (lower blood pressure and subjective anxiety). These contrasting fortunes are attributed to two sets of factors: technical and managerial. The technical design philosophy at Manchester followed what may be called a “tool paradigm” (the system was designed to support/augment the human role) whereas the London project was highly Tayloristic. Implementation at Manchester was also adroitly managed (strong leadership, good staff communication) in contrast to London (weak management, poor industrial relations). The successful deployment in the study of a psychophysiological methodology demonstrates the diagnostic power of this multi-perspective approach, and illustrates its considerable potential in IS research/practice in relation to the design and evaluation of information systems.