Team Situation Awareness (TSA) is one of the critical factors in effective Operating Room (OR) teamwork and can impact patient safety and quality of care. While previous research showed a relationship between situation awareness, as measured by communication events, and team performance, the implications for developing technology to augment and facilitate TSA were not examined. This research aims to further study situation-related communications in the cardiac OR in order to uncover potential degradation in TSA which may lead to adverse events. The communication loop construct-the full cycle of information flow between the participants in the sequence-was used to assess susceptibility to breakdown. Previous research and the findings here suggest that communication loops that are open, non-directed, or with delayed closure, can be susceptible to information loss. These were quantitatively related to communication indicators of TSA such as questions, replies, and announcements. Taken together, both qualitative and quantitative analyses suggest that a high proportion of TSA-related communication (63%) can be characterized as susceptible to information loss. The findings were then used to derive requirements and design a TSA augmentative display. The design principles and potential benefits of such a display are outlined and discussed.

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This paper outlines an empirical method to analyze human communication in the context of a cardiac Operating Room (OR) and derive design requirements for a team-oriented information display. Its first phase was to identify and categorize shared information within teamwork. The subsequent analysis of the shared information included aggregating shared information instances into unique items, and then scoping and generating the display requirements. The analysis resulted in 52 unique shared information items out of 845 information sharing instances. These unique information items were considered as the requirements for a cardiac OR team-oriented display. While the method was implemented on operating room teamwork, it can be generalized to a variety of domains with a need for a team-oriented display.

The nursing handoff is a fundamental aspect of continued patient care that involves the transfer of vital medical information through various means. This project qualitatively examined nursing dyads to determine the types of resources used during handoffs and their frequency through the theoretical framework of distributed cognition. Forty handoffs between nurses, with experience ranging from 3 to 40 or more years, were observed within the intensive care unit of a pediatric hospital. The findings revealed that a variety of resources were referred to and appear mildly correlated with handoff durations, where more experienced individuals displayed a greater frequency of resource use in prolonged handoffs.

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