The Patient as a construction and a non-participant member of a change-process.

The contribution of this paper is a discussion about how the patient as a phenomenon is constructed and used by employees for different purposes, enabling and inhibiting change. The results are based on a three year case study in which data has been collected with interviews and observations. They have then been analyzed and interpreted within a framework consisting of theories about thinking collectives, structuration, information and knowledge management. The findings indicate that “the patient” has implications for how project management is conducted and a patient record upgraded at the anesthesia and intensive care unit of a hospital.