Journal of Healthcare Engineering

Journal of Healthcare Engineering / 2010 / Article

Research Article | Open Access

Volume 1 |Article ID 643180 | 22 pages | https://doi.org/10.1260/2040-2295.1.2.255

Healthcare Team Performance in Time Critical Environments: Coordinating Events, Foraging, and System Processes

Abstract

This review paper addresses issues in how healthcare providers search, obtain, and share resources in provider teams. Based in part on a System of Systems (SoS) analysis of provider coordination and resource flows, this paper expands the concepts of resource foraging theory and event dynamics to develop systematic methods for studying healthcare provider coordination. Process flow and human factors emphases from industrial engineering are used to address critical concerns of single-scale and multi-scale performance in healthcare delivery settings. Provider strategies for acquiring the information and resources needed for successful healthcare delivery are dependent on interactions between task requirements, time constraints, and provider coordination processes, as well as limitations of information and resource flow capabilities. These improved definitions and measures will enhance engineers' ability to contribute to improved patient care timeliness, effectiveness, quality, and safety.

References

  1. T. J. Anderson, S. Vasatko, B. S. Caldwell, and J. Bonnet, “Active and design phases of laboratory information systems: a human-centered analysis for continuous improvement,” in Human Factors in Organizational Design and Management - V, V., O. Brown Jr., and H. W. Hendrick, Eds., pp. 43–48, North-Holland, Amsterdam, 1996. View at: Google Scholar
  2. K. C. Boustany and B. S. Caldwell, “Information Coordination in Healthcare Providers,” in Proceedings of the 2007 Industrial Engineering Research Conference, Nashville, TN, 2007. View at: Google Scholar
  3. B. S. Caldwell and S. K. Garrett, “Coordination of Healthcare Expertise and Information Flow in Provider Teams,” in Proceedings of the 16th World Congress of the International Ergonomics Association, pp. 3565–3570, Maastricht, Netherlands, 2006. View at: Google Scholar
  4. S. K. Garrett and B. S. Caldwell, “Task Coordination and Group Foraging in Health Care Delivery Teams,” in Proceedings of the Human Factors and Ergonomics Society 50th Annual Meeting, pp. 1059–1063, San Francisco, 2006. View at: Google Scholar
  5. S. K. Garrett and J. B. Craig, “Medication Administration and the Complexity of Nursing Workflow,” in Proceedings of the Institute of Industrial Engineers Society of Health Systems Conference, Chicago, 2009. View at: Google Scholar
  6. B. S. Caldwell, “Knowledge sharing and expertise coordination of event response in organizations,” Applied Ergonomics (Special Issue on Macroergonomics), vol. 39, pp. 427–438, 2008. View at: Google Scholar
  7. B. S. Caldwell, “Multi-Team Dynamics and Distributed Expertise in Mission Operations,” Aviation, Space, and Environmental Medicine, vol. 76, pp. Sec II, B145–B153, 2005. View at: Google Scholar
  8. B. S. Caldwell and T. J. Anderson, “Design and Active Phases of Medical Process Improvement Systems,” in Examining Errors in Health Care: Developing a Prevention, Education and Research Agenda, Rancho Mirage, CA, 1996. View at: Google Scholar
  9. B. S. Caldwell and N. C. Everhart, “Information Flow and Development of Coordination in Distributed Supervisory Control Teams,” International Journal of Human-Computer Interaction, vol. 10, pp. 51–70, 1998. View at: Google Scholar
  10. S. K. Garrett and B. S. Caldwell, “Describing functional requirements for knowledge sharing communities,” Behaviour and Information Technology, vol. 21, pp. 359–364, 2002. View at: Google Scholar
  11. S. K. Garrett and B. S. Caldwell, “Mission Control Knowledge Synchronization: Operations to Reference Performance Cycles,” in Proceedings of the Human Factors and Ergonomics Society 46th Annual Meeting, pp. 849–853, Santa Monica, CA, 2002. View at: Google Scholar
  12. S. K. Garrett and B. S. Caldwell, “Human Factors Aspects of Planning and Response to Pandemic Events,” in IIE Industrial Engineering Research Conference, pp. 705–711, Miami, 2009. View at: Google Scholar
  13. C. o. Q. o. H. C. i. A. IOM, To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press, 2000.
  14. P. Reed, W. D. Compton, J. H. Grossman, and G. Fanjiang, Eds., Building A Better Delivery System: A New Engineering / Health Care Partnership, The National Academies Press, Washington, DC, 2005.
  15. IOM, Crossing the Quality Chasm: A New Health System for the 21st Century, National Academy Press, Washington, D. C., 2001.
  16. L. L. Leape, “Human Factors Meetings Health Care: The Ultimate Challenge,” in in Ergonomics in Design, vol. 12, pp. 6–12, Human Factors and Ergonomics Society, Santa Monica, CA, 2004. View at: Google Scholar
  17. P. R. Ebright, E. S. Patterson, B. A. Chalko, and M. L. Render, “Understanding the Complexity of Registered Nurse Work in Acute Care Settings,” Journal of Nursing Administration, vol. 33, pp. 630–638, 2003. View at: Google Scholar
  18. P. R. Ebright, “Understanding Nurse Work,” Clinical Nurse Specialist, vol. 18, pp. 168–170, 2004. View at: Google Scholar
  19. M. S. Bogner, “Human Error in Medicine: A Frontier for Change,” in Human Error in Medicine, M. S. Bogner, Ed., pp. 373–383, Lawrence Erlbaum Associates, Hillsdale, NJ, 1994. View at: Google Scholar
  20. P. R. Ebright, E. S. Patterson, and M. L. Render, “The “New Look” Approach to Patient Safety,” Clinical Nurse Specialist, vol. 16, pp. 247–253, 2002. View at: Google Scholar
  21. P. R. Ebright and K. Rapala, “Blame—Do You Know It When You See It?” Outcomes Management, vol. 7, pp. 91–93, 2003. View at: Google Scholar
  22. M. W. Maier, “Architecting Principles for Systems of Systems,” Systems Engineering, vol. 1, pp. 267–284, 1998. View at: Google Scholar
  23. E. Ahmed and A. S. Hegazi, “On dynamical multi-team and signaling games,” Applied Mathematics and Computation, vol. 172, pp. 524–530, 2006. View at: Google Scholar
  24. E. Ahmed, A. S. Hegazi, M. F. Elettreby, and S. S. Askar, “On multi-team games,” Physica A, vol. 369, pp. 809–816, 2006. View at: Google Scholar
  25. Y. Liu and M. A. Simaan, “Noninferior Nash Strategies for Multi-Team Systems,” Journal Of Optimization Theory and Applications, vol. 120, pp. 29–51, 2004. View at: Google Scholar
  26. Y. Liu, M. A. Simaan, and J. B. Cruz Jr., “An application of dynamic Nash task assignment strategies to multi-team military air operations,” Automatica, vol. 39, pp. 1469–1478, 2003. View at: Google Scholar
  27. J. S. Osmundson, “A Systems Engineering Methodology for Information Systems,” Systems Engineering, vol. 3, pp. 68–76, 2000. View at: Google Scholar
  28. J. S. Osmundson, T. V. Huynh, and G. O. Langford, “Emergent Behavior in Systems of Systems,” in Proceedings of the Conference on Systems Engineering Research, pp. 1–10, Los Angeles, CA, 2008. View at: Google Scholar
  29. P. B. Checkland and J. Scholes, Soft Systems Methodology in Action, John Wiley & Sons, Chichester, UK, 1990.
  30. R. Kopach-Konrad, M. Lawley, M. Criswell et al., “Applying Systems Engineering Principles in Improving Health Care Delivery,” Journal of General Internal Medicine, vol. 22, pp. 431–437, 2007. View at: Google Scholar
  31. R. Kopach, P.-C. DeLaurentis, M. Lawley et al., “Effects of clinical characteristics on successful open access scheduling,” Health Care Management Science, vol. 10, pp. 111–124, 2007. View at: Google Scholar
  32. S. K. P. Garrett, “Provider Centered Coordination, Resource Foraging, and Event Management in Healthcare Tasks,” unpublished Doctoral Dissertation. West Lafayette, IN: Purdue University, 2008. View at: Google Scholar
  33. K. Ye, D. Taylor, J. C. Knott, A. Dent, and C. E. MacBean, “Handover in the emergency department: Deficiencies and adverse effects,” Emergency Medicine Australasia, vol. 19, pp. 433–441, 2007. View at: Google Scholar
  34. K. R. Klein, D. C. Brandenburg, J. G. Atlas, and A. Maher, “The Use of Trained Observers as an Evaluation Tool for a Multi-Hospital Bioterrorism Exercise,” Prehospital and Disaster Medicine, vol. 20, pp. 159–163, 2005. View at: Google Scholar
  35. D. DeLaurentis and W. Crossley, “A Taxonomy-based Perspective for System of Systems Design Methods,” in Proceedings of IEEE Systems, Man & Cybernetics Conference, p. Paper No. 0-7803-9298-1/05, 2005. View at: Google Scholar
  36. J. Park, W. Jung, J. Ha, and Y. Shin, “Analysis of Operators' Performance Under Emergencies Using a Training Simulator of the Nuclear Power Plant,” Reliability Engineering and System Safety, vol. 83, pp. 179–186, 2004. View at: Google Scholar
  37. D. DeLaurentis, “Understanding Transportation as a System-of-Systems Design Problem,” in 43rd AIAA Aerospace Sciences Meeting and Exhibit, p. Paper No. 2005–123, 2005. View at: Google Scholar
  38. R. S. Pei, “Systems-of-Systems Integration (SoSI)—A Smart Way of Acquiring Army C4I2WS Systems,” in Proceedings of the Summer Computer Simulation Conference, pp. 574–579, 2000. View at: Google Scholar
  39. W. H. Manthorpe Jr., “The Emerging Joint System of Systems: A Systems Engineering Challenge and Opportunity for APL,” John Hopkins APL Technical Digest, vol. 17, pp. 305–313, 1996. View at: Google Scholar
  40. J. A. Casazza and F. Delea, Understanding Electric Power Systems: An Overview of the Technology and the Marketplace, John Wiley & Sons, New York, 2003.
  41. A.-M. Neutel, J. A. Heesterbeek, and P. C. deRuiter, “Stability in Real Food Webs: Weak Links in Long Loops,” Science, vol. 296, pp. 1120–1123, 2002. View at: Google Scholar
  42. B. S. Caldwell, “Components of Information Flow to Support Coordinated Task Performance,” International Journal of Cognitive Ergonomics, vol. 1, pp. 25–41, 1997. View at: Google Scholar
  43. B. S. Caldwell, “Information and Communication Technology Needs for Distributed Communication and Coordination During Expedition-Class Space Flight,” Aviation, Space, and Environmental Medicine, vol. 71, pp. A6–A10, 2000. View at: Google Scholar
  44. H. M. Cuevas, S. M. Fiore, B. S. Caldwell, and L. Strater, “Augmenting Team Cognition in Human-Automation Teams Performing in Complex Operational Environments,” Aviation, Space, and Environmental Medicine, vol. 78, pp. B63–70, 2007. View at: Google Scholar
  45. H. M. Cuevas, S. M. Fiore, E. Salas, and C. A. Bowers, “Virtual Teams as Sociotechnical Systems,” in Virtual and Collaborative Teams: Process, Technologies, and Practice, S. H. Godar and P. Ferris, Eds., Idea Group Publishing, Hershey, PA, 2004. View at: Google Scholar
  46. K. C. Boustany, “A System-of-Systems Examination of Humans in Multi-Site Healthcare Coordination Under Nominal and Degraded Conditions,” unpublished Master's Thesis. West Lafayette, IN: Purdue University, 2008. View at: Google Scholar
  47. A. Worm, “Evaluating Tactical Real-Time Interaction in Multi-Agent, Dynamic, Hazardous, High-Stake Operations,” in Proceedings of the Human Factors and Ergonomics Society 43rd Annual Meeting, pp. 199–203, Houston, 1999. View at: Google Scholar
  48. C. S. Holling, “Some Characteristics of Simple Types of Predation and Parasitism,” The Canadian Entomologist, vol. XCI, pp. 385–398, 1959. View at: Google Scholar
  49. D. M. Russell, M. J. Stefik, P. Pirolli, and S. K. Card, “The Cost Structure of Sensemaking,” in INTERCHI '93, pp. 269–276, Amsterdam, 1993. View at: Google Scholar
  50. P. Pirolli and S. Card, “Information Foraging,” Psychological Review, vol. 106, pp. 643–675, 1999. View at: Google Scholar
  51. P. Pirolli and S. K. Card, “Information Foraging in Information Access Environments,” in CHI'95: Mosaic of Creativity, pp. 51–58, New York, 1995. View at: Google Scholar
  52. G. Mantovani, “The Psychological Construction of the Internet: From Information Foraging to Social Gathering to Cultural Mediation,” CyberPsychology & Behavior, vol. 4, pp. 47–56, 2001. View at: Google Scholar
  53. A. Wexelblat and P. Maes, “Footprints: History-Rich Tools for Information Foraging,” in CHI 1999, pp. 270–277, 1999. View at: Google Scholar
  54. P. E. Sandstrom, “An Optimal Foraging Approach To Information Seeking And Use,” Library Quarterly, vol. 64, pp. 414–449, 1994. View at: Google Scholar
  55. W. H. Durham, “Overview: Optimal Foraging Analysis in Human Ecology,” in Hunter-Gatherer Foraging Strategies: Ethnographic and Archeological Analyses, B. Winterhalter and E. A. Smith, Eds., pp. 218–231, The University of Chicago Press, Chicago, 1981. View at: Google Scholar
  56. S. K. Garrett, B. S. Caldwell, E. C. Harris, and M. C. Gonzalez, “Six Dimensions of Expertise: A More Comprehensive Definition of Cognitive Expertise for Team Coordination,” Theoretical Issues in Ergonomics Science, vol. 10, pp. 93–105, 2009. View at: Google Scholar
  57. N. J. Cooke, P. A. Kiekel, and E. E. Helm, “Measuring Team Knowledge During Skill Acquisition of a Complex Task,” International Journal of Cognitive Ergonomics, vol. 5, pp. 297–315, 2001. View at: Google Scholar
  58. B. S. Caldwell, “Distributed Supervisory Coordination with Multiple Operators and Remote Systems,” in IEEE International Conference on Systems, Man and Cybernetics, pp. 442–447, Washington, DC, 2003. View at: Google Scholar
  59. G. H. Avery, M. Lawley, S. K. Garrett et al., “Planning for Pandemic Influenza: Lessons from the Experiences of Thirteen Indiana Counties,” Journal of Homeland Security and Emergency Management, vol. 5, p. Article 29, 2008. View at: Google Scholar
  60. B. S. Caldwell and S. K. Garrett, “Team-Based Coordination of Event Detection and Task Management in Time-Critical Settings,” in 8th International Conference on Naturalistic Decision Making, Pacific Grove, CA, 2007. View at: Google Scholar
  61. S. K. Garrett, B. S. Caldwell, and P. R. Ebright, “Provider Information and Resource Foraging in Health Care Delivery,” International Journal of Collaborative Enterprise, in press. View at: Google Scholar
  62. K. C. Boustany and B. S. Caldwell, “Dimensions of Information and Resource Flow in Healthcare Systems,” in Proceedings of the Human Factors and Ergonomics Society 51st Annual Meeting, pp. 1268–1271, Baltimore, 2007. View at: Google Scholar
  63. B. S. Caldwell, “Issues of Task and Temporal Coordination in Distributed Expert Teams,” in Proceedings of the 16th World Congress of the International Ergonomics Association, pp. 2761–2766, Maastricht, Netherlands, 2006. View at: Google Scholar
  64. B. S. Caldwell, R. C. Palmer III, and H. M. Cuevas, “Information alignment and task coordination in organizations: An ‘information clutch’ metaphor,” Information Systems Management (Special Issue: “Collaboration Challenges: Bridging the IT Support Gap”), vol. 25, pp. 33–44, 2008. View at: Google Scholar
  65. R. L. Helmreich and A. C. Merritt, “Safety and error management: The role of Crew Resource Management,” in Aviation Resource Management, B. J. Hayward and and A. R. Lowe, Eds., pp. 107–119, Ashgate, Aldershot, UK, 2000. View at: Google Scholar
  66. R. L. Helmreich and A. C. Merritt, Culture at Work in Aviation and Medicine: National, Organizational and Professional Influences, Ashgate Publishing LTD, Hampshire, UK, 1998.
  67. D. A. Randall and C. M. Seaberry, Contingency Contracting and the IT Manager: Today's Challenges and Future Implications, Naval Postgraduate School, Monterey, CA, 2009.
  68. S. Levin, D. J. France, R. Hemphill et al., “Tracking Workload in the Emergency Department,” Human Factors, vol. 48, pp. 526–539, 2006. View at: Google Scholar
  69. T. C. Germann, K. Kadau, I. M. Longini, and C. A. Macken, “Mitigation Strategies for Pandemic Influenza in the United States,” Proceedings of the National Academy of Sciences in the United States of America, vol. 103, pp. 5935–5940, 2006. View at: Google Scholar
  70. A. Newell, Unified Theories of Cognition, Harvard University Press, Cambridge, MA, 1990.
  71. N. Charness, “Expertise in Chess: The Balance Between Knowledge and Search,” in Toward a General Theory of Expertise: Prospects and Limits, K. A. Ericsson and J. Smith, Eds., pp. 39–63, University Press, Cambridge, UK, 1994. View at: Google Scholar

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