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The English National Health Service has undergone unprecedented political, economic and technological change. This has resulted in a requirement for radical improvements in operational efficiency and effectiveness. An effective IT infrastructure supporting key operational processes and management reporting is now seen as essential. This paper outlines the findings from empirical research in a North East hospital Trust. The authors collaborated on a requirements analysis project to investigate and model business processes and information flows using an automated IDEF0 software tool. A participatory action research framework was used, informed by principles derived from critical social theory, to describe the complexity of the situation and provide improved communication amongst stakeholders. The paper concludes by reflecting on the need for more “ideal” speech situations in order to deal with complex operations management problems where political, power and social issues can obstruct effective implementation of new computer‐integrated operations.

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