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Temporal coordination: On time and coordination of collaborative activities at a surgical department. Computer Supported Cooperative Work (CSCW): (2000)

by Jakob E Bardram
Venue:The Journal of Collaborative Computing,
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A Finger on the Pulse: Temporal Rhythms and Information Seeking in Medical Work

by Madhu Reddy, Paul Dourish , 2002
"... Most cooperative work takes place in information-rich environments. However, studies of "information work" tend to focus on the decontextualized access and retrieval problems faced by individual information seekers. Our work is directed towards understanding how information management is s ..."
Abstract - Cited by 96 (10 self) - Add to MetaCart
Most cooperative work takes place in information-rich environments. However, studies of "information work" tend to focus on the decontextualized access and retrieval problems faced by individual information seekers. Our work is directed towards understanding how information management is seamlessly integrated into the course of everyday activities. Drawing on an ethnographic study of medical work, we explore the relationship between information and temporal coordination and discuss the role of temporal patterns or "rhythms" in providing individuals with the means to coordinate information and work.

Cognitive properties of a whiteboard: a case study in a trauma centre

by Yan Xiao, Caterina Lasome, Jacqueline Moss, Colin F. Mackenzie - Proc. ECSCW , 2001
"... edu, Abstract. Distributed cognition as an approach to collaborative work holds that a work unit is cognitive system in which cognitive activities are carried out jointly by workers with the use of tools. This approach has several direct implications to the study of collaborative work In this paper, ..."
Abstract - Cited by 47 (2 self) - Add to MetaCart
edu, Abstract. Distributed cognition as an approach to collaborative work holds that a work unit is cognitive system in which cognitive activities are carried out jointly by workers with the use of tools. This approach has several direct implications to the study of collaborative work In this paper, we analysed staff interactions with a large display board in a Level I trauma centre operating room unit. Coordination needs are exacerbated by the unpredictability of incoming emergency surgery patients admitted to the trauma centre as well as other contingencies (such as changes in scheduled surgery cases or staffing) The public display board has evolved into a key component for supporting collaborative work. The physical and perceptual properties of the board are exploited by the clinicians to support rapid paced, highly dynamic work. The canvas-like appearances of the display board, combined with magnetic objects attached to the board, afford its users to taylor the board as an effective coordinative tool and to invent new ways of representing information Based on the concept of display-based cognition, our analysis illustrates the role of public displays in facilitating negotiation of scheduling, joint planning, and augmenting inter-personal communication.
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...ntion to the work environment and to the way in which people exploit and inventively use the physical and perceptual properties of the work environment (e.g. Hutchins, 1995b; Segal, 1994; Berg, 1999; =-=Bardram, 2000-=-), much can be learnt still about collaborative work. An equally compelling reason for studying artefacts in collaborative work is to inform design. Increasingly human collaborative activities are med...

Moving to get aHead: Local Mobility and Collaborative Work

by Jakob E. Bardram, Claus Bossen - In CSCW
"... Abstract: Local mobility is a central aspect of collaborative work that is in need of close analysis. Between the face-to-face interaction of offices or control rooms and long-distance interaction facilitated through e.g. telephones, e-mail, the www or teleconfer-ences lie a number of work-settings ..."
Abstract - Cited by 23 (3 self) - Add to MetaCart
Abstract: Local mobility is a central aspect of collaborative work that is in need of close analysis. Between the face-to-face interaction of offices or control rooms and long-distance interaction facilitated through e.g. telephones, e-mail, the www or teleconfer-ences lie a number of work-settings in which actors move about continuously in order to accomplish their work. They do so because they need to get access to knowledge, re-sources, persons and/or places. We analyze the integral nature of mobility to this kind of work practice from the ethnographic description of a hospital department, and the chal-lenges that actors have to face to accomplish their work. Based on this ethnographic case, we propose a set of concepts for understanding local mobility as an intermediate field of distributed cooperation between centres of coordination and remote collaboration. Finally, we introduce the concept of ‘mobility work ’ as complementary to the concept of ‘articulation work’.
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...dination and reaching common understanding, and can only at a superficial level be understood through a rational means-end scheme (Strauss 1993:p20). In CSCW this has lead to a focus on coordination (=-=Bardram 2000-=-, Schmidt & Simone 1996), which has a temporal as well as a spatial dimension – the latter of which is often overlooked. As Strauss (1993), amongst many other authors, points out, actors not only have...

Work coordination, workflow, and workarounds in a medical context

by Marina Kobayashi, Susan R. Fussell - Proc. Of CHI’05 , 2005
"... In this paper we report an ethnographic study of workarounds—informal temporary practices for handling exceptions to normal workflow—in a hospital environment. Workarounds are a common technique for dealing with the inherent uncertainty of dynamic work environments. Workarounds can help coordinate w ..."
Abstract - Cited by 13 (1 self) - Add to MetaCart
In this paper we report an ethnographic study of workarounds—informal temporary practices for handling exceptions to normal workflow—in a hospital environment. Workarounds are a common technique for dealing with the inherent uncertainty of dynamic work environments. Workarounds can help coordinate work, especially under conditions of high time pressure, but they may result in information or work protocols that are unstable, unavailable, or unreliable. We investigated workarounds and their effects through observation and interviews in a major teaching medical center. Our results suggest 4 key features of workarounds that technologies might help address: (a) workarounds differ as a function of people’s role; (b) workarounds draw on tacit knowledge of others’ abilities and willingness to help; (c) workarounds can have a cascading effect, causing other workarounds down the line; (d) workarounds often rely on principles of fairness and who owes whom a favor. We provide recommendations for designing systems to better support workarounds in dynamic environments.
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...the operating rooms are booked, the staff might perform the operation in the Trauma Resuscitation Unit, which is actually an admitting area. Although workarounds are common in medical settings [e.g., =-=[1]-=-, [7]], little research has attempted to characterize properties of workarounds that might influence their effectiveness. By describing short-term benefits of workarounds (providing temporary fixes to...

Evaluating the Deployment of a Mobile Technology in a Hospital Ward

by Charlotte Tang, Sheelagh Carpendale - Proc. CSCW 2008
"... Since health care teams are often distributed across time and location, information sharing is crucial for effective patient care. Studying the use of a mobile information technology in a local hospital ward at two months and eleven months after its deployment identifies both shortand long-term phen ..."
Abstract - Cited by 9 (4 self) - Add to MetaCart
Since health care teams are often distributed across time and location, information sharing is crucial for effective patient care. Studying the use of a mobile information technology in a local hospital ward at two months and eleven months after its deployment identifies both shortand long-term phenomena and reveals a mismatch between the intentions behind the deployed mobile technology and the nurses ’ current work practices. We contrast the new mobile technology with the paper artifacts that were previously relied upon in nursing work. Finally, in light of these findings, we suggest design directions for future technology to support the nursing shift work. Author Keywords Observation, shift change, information flow, mobile
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...m as well as timely availability of specific information artifacts [6,17]. Traditionally in medical settings, information sources exist in a variety of media such as verbal, paper, and display medium =-=[2,4,10,14,27]-=-. Verbal communication is wellknown to be effective in interpersonal communication, particularly during face-to-face conversations with the use of visual aids like gestures [3,11,25]. Large displays s...

Transactive memory in trauma resuscitation

by Ra Sarcevic, Ivan Marsic, Michael E. Lesk, Randall S. Burd - in CSCW ’08: Proceedings of the ACM 2008 conference on Computer supported cooperative work , 2008
"... This paper describes an ethnographic study conducted to explore the possibilities for future design and development of technological support for trauma teams. We videotaped 10 trauma resuscitations and transcribed each event. Using a framework that we developed, we coded each transcript to allow qua ..."
Abstract - Cited by 9 (7 self) - Add to MetaCart
This paper describes an ethnographic study conducted to explore the possibilities for future design and development of technological support for trauma teams. We videotaped 10 trauma resuscitations and transcribed each event. Using a framework that we developed, we coded each transcript to allow qualitative and quantitative analysis of the trauma teams ’ collaborative processes. We analyzed teams ’ tasks, interactions, and communication patterns that support information acquisition and sharing. Our results showed the importance of team transactive memory, but also pointed to inefficiencies in communication processes, which enable the functioning of this collective memory system. Based on quantitative and qualitative observations of trauma teamwork, we present opportunities for technological solutions that may reduce the cognitive effort needed for maintaining the working memory of trauma teams. Author Keywords Teamwork, communication, transactive memory, cognitive
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...ses of tacit work practices and procedures, these studies have mostly focused on the social and interactional character of organizational activities in operating rooms, anesthesia, and hospital wards =-=[2,12,16, 22]-=-. Despite this tradition of research on teamwork in timeand safety-critical work settings within CSCW community, trauma resuscitation remains relatively understudied. While some commonalities exist be...

Why the Plan Doesn’t Hold – a Study of Situated Planning, Articulation and Coordination Work in a Surgical Ward

by Jakob E. Bardram
"... Most studies of plans and situated work have applied ethnographic methods and and thus fail to provide any quantitative insight into the extent of this phenomenon. We present a study of planning and executing operations in an operating suite. Quantitative analysis of log data reveals the extent to w ..."
Abstract - Cited by 8 (2 self) - Add to MetaCart
Most studies of plans and situated work have applied ethnographic methods and and thus fail to provide any quantitative insight into the extent of this phenomenon. We present a study of planning and executing operations in an operating suite. Quantitative analysis of log data reveals the extent to which operation schedules are carried out as planned, and qualitative studies reveal the reasons behind changes to the plan, the consequences of such changes, and the strategies used to cope with them. 67 % of the plan is changed and only 56 % of all operations are planned ahead. We discuss how operation schedules are subject to “continuous planning”, and how this needs to be supported by technology. ACM Classification Keywords
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...portation timetables, aviation checklists, operations schedules, scientific classification systems, and software bug reporting systems. A number of studies have investigated coordination in hospitals =-=[1, 3, 10]-=-. In this setting, stable coordination mechanisms are particularly useful because of the safety-critical nature of the work, because people work in a highly distributed and mobile way [4], and because...

Supporting Coordination in Surgical Suites: Physical Aspects of Common Information Spaces

by Peter Scupelli, Yan Xiao, Susan R. Fussell, Sara Kiesler, Mark D. Gross
"... To accommodate frequent emergencies, interruptions, and delays, hospital staff continually make and coordinate changes to the surgery schedule. The technical and social aspects of coordination in surgical suites have been described by prior studies. This paper addresses an understudied aspect of coo ..."
Abstract - Cited by 7 (1 self) - Add to MetaCart
To accommodate frequent emergencies, interruptions, and delays, hospital staff continually make and coordinate changes to the surgery schedule. The technical and social aspects of coordination in surgical suites have been described by prior studies. This paper addresses an understudied aspect of coordination: the physical environment. Based on a field study of four surgical suites in two large academic centers, we show how the physical layout of hallways and rooms, and barriers and spaces around displays and key coordinators, support or fail to support the common information spaces used for coordination. We use the concept “information hotspots ” to represent how physical places and their characteristics facilitate coordination. We developed design principles based on the concept of information hotspots that should guide architectural considerations for coordination in dynamic environments such as hospitals. Author Keywords Coordination; physical environment; shared displays;
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...oning a non-urgent surgery versus requiring nurses to stay overtime. Such negotiations require synchronizing tasks across groups, time, and place, and estimating physical resources and staff workload =-=[6]-=-. To support these work processes, hospital staff rely on a variety of artifacts, including paper schedules, electronic records, whiteboards, and mobile devices [e.g., 40, 48, 56, 33]. Together with p...

Temporal Implications of Information Technology for Work Practices: Organizing in and for Time in an Emergency Department

by Zixing Shen, Youngjin Yoo, Kalle Lyytinen
"... We investigate the temporal implications of information technology by examining its use in the work practices of physicians and nurses in an emergency department. We conceptualize the temporality in work practices being constituted by temporal enactment (e.g., linearity), temporal construal (e.g., a ..."
Abstract - Cited by 5 (0 self) - Add to MetaCart
We investigate the temporal implications of information technology by examining its use in the work practices of physicians and nurses in an emergency department. We conceptualize the temporality in work practices being constituted by temporal enactment (e.g., linearity), temporal construal (e.g., autonomy), and temporal spatiality (e.g., regionalization). By using this categorization we found that information technology impinges on temporal organizing by imposing its specific temporal logics and by being location dependent. Distinct information technologies have different impacts on temporality in work, and temporal effects of the same information technology vary across work groups. This highlights the need for alternative technological configurations to support varying temporal practices. The findings underscore the potential of information technology as a temporal boundary object that reconciles differences in temporal organization among work groups.
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...004), on temporal coordination mechanisms, such as allocating, scheduling and synchronizing, used by distributed groups that interact through information technology medium to accomplish a task (e.g., =-=Bardram 2000-=-; Massey et al 2003), and on changes in temporal organization of work induced by information technology in workplace (e.g., Barley 1988; Lee and Liebenau 2000). While these studies have examined how i...

Loosely formed patient care teams: Communication challenges and technology design

by Soyoung Lee , Charlotte Tang , Sun Young Park , Yunan Chen - In Proc. CSCW 2012, ACM Press , 2012
"... ABSTRACT We conducted an observational study to investigate nurses' communication behaviors in an Emergency Department (ED). Our observations reveal unique collaboration practices exercised by ED staff, which we term as "loosely formed team collaboration." Specifically, ED patient ca ..."
Abstract - Cited by 4 (1 self) - Add to MetaCart
ABSTRACT We conducted an observational study to investigate nurses' communication behaviors in an Emergency Department (ED). Our observations reveal unique collaboration practices exercised by ED staff, which we term as "loosely formed team collaboration." Specifically, ED patient care teams are dynamically and quickly assembled upon patient arrival, wherein team members engage in interdependent and complex care activities. The responsible care team then disassembles when a patient leaves the ED. The coordination mechanism required for these work practices challenges nurses' communication processes, often increasing breakdown susceptibility. Our analysis of the ED nurses' communication behaviors and use of communication channels highlights the importance of maintaining team awareness and supporting role-based communication. This points to the need for explicit efforts to coordinate tasks and informative interruptions. These findings call for the design of future communication technologies to meet the needs of loosely formed collaborative environments to provide team-based communication, lightweight feedback, and information transparency.
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...ated the collaborative work through a variety of cues including eavesdropping of conversations and subsequent responses. Yet, the knowledge gained from studying the collaborative behaviors in these relatively stable work environments may not be applicable to the highly dynamic team collaborations, such as the medical setting. Comparing with these settings, collaboration in medical field is more complex and dynamic [3, 6, 17, 31]. As such, much research has been conducted to examine important aspects core to work coordination and collaboration in healthcare. These include temporal coordination [2, 24], shift cycles [38], spatiality [3], artifact use [37], redundancy [8, 33], sense-making [23], information sharing [31], and communication breakdowns [24, 35] and workflows [9]. In particular, it has been found that improving coordinationrelated communication can potentially increase work efficiency in patient care [14]. This is particularly relevant to nursing work as nurses have been found to spend more than 30% of their time on communication-related activities during work [14]. Collaboration in time-critical medical settings is characterized by rapid configuration and reconfiguration of tea...

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