Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit

Ashoori, Maryam; Burns, Catherine M.; D’Entremont, Barbara; Momtahan, Kathryn

doi:10.1080/00140139.2014.909949

Cited by 52 publications

(32 citation statements)

References 35 publications

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“…Effken et al 2001, Miller 2004, Sharp and Helmicki 1998. Other applications include the development of decision support tools (Hajdukiewicz et al 2001;Effken et al 2011), understanding of contributors to inpatient falls (Lopez et al 2010), inpatient medication management system (Pingenot et al 2009) and team working (Ashoori et al 2014). …”

Section: Work Domain Analysis (Wda)mentioning

confidence: 99%

Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study

2015

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A c c e p t e d M a n u s c r i p t 2 Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study. AbstractMedication safety and errors are a major concern in care homes. In addition to the identification of incidents, there is a need for a comprehensive system description to avoid the danger of introducing interventions that have unintended consequences and are therefore unsustainable. The aim of the study was to explore the impact and uniqueness of Work Domain Analysis (WDA) to facilitate an in-depth understanding of medication safety problems within the care home system and identify the potential benefits of WDA to design safety interventions to improve medication safety. A comprehensive, systematic and contextual overview of the care home medication system was developed for the first time. The novel use of the Abstraction Hierarchy (AH) to analyse medication errors revealed the value of the AH to guide a comprehensive analysis of errors and generate system improvement recommendations that took into account the contextual information of the wider system. Keywords: care homes, nursing homes, human factors, medication safety, patient safety, work domain analysis Practitioner summaryIt is widely acknowledged that a systems approach is necessary to improve medication safety. This study used a cognitive engineering method, Work Domain Analysis, to map the care home medication system and analyse medication errors. A macro-level view of the system was developed and this has provided a knowledge base for future interventions.

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Section: Work Domain Analysis (Wda)mentioning

confidence: 99%

Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study

2015

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“…Other applications include, for example, analysis of complex socio-technical systems (Stanton & Bessell 2014), analysis of team cognitive work (Ashoori et al 2014), and development of decision aids in healthcare (Dhukaram & Baber 2015). The decision ladder also has descriptive value, especially when used as a template with which to analyse verbal protocols (Vicente 1999).…”

Section: Decision Process Structurementioning

confidence: 99%

Assessing the structure of non-routine decision processes in Airline Operations Control

Richters

Schraagen²,

Heerkens

2015

Ergonomics

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ControlUnfamiliar severe disruptions challenge airline operations control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of airline operations control professionals' decision process during unfamiliar disruptions by mapping three macrocognitive activities on the decision ladder: sensemaking, option evaluation, and action planning. The relationship between this structure and decision quality was measured. A simulated task was staged, based on which think aloud protocols were obtained. Results show that the general decision process structure resembles the structure of experts working under routine conditions, in terms of the general structure of the macrocognitive activities, and the rule-based approach used to identify options and actions.Surprisingly, high quality of decision outcomes was found to relate to the use of rule-based strategies. This implies that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing.Keywords: decision making; airline operations control; fractionated expertise; macrocognitive activitiesWe examined the macrocognitive structure of airline operations control professionals' decision process during a simulated unfamiliar disruption in relation to decision quality. Results suggest that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing.

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“…In their study of medical teams using team Cognitive Work Analysis, Ashoori et al (2014) suggested that team strategies could be assessed against four categories:…”

Section: Team Strategies Analysismentioning

confidence: 99%

“…Ashoori et al (2014) found that team Work Domain Analysis provided information about shared boundary objects, shared elements of the information space in surgical teams. In support of the findings of Ashoori et al (2014), this study also The Work Domain Analysis also identified that the agencies share many of the same boundary objects in order to achieve their tasks. Shared boundary objects need to be adaptable to all traffic incident management requirements and seamless across agencies.…”

Section: Team Work Domain Analysis Findingsmentioning

confidence: 99%

“…This supports the finding from the analysis of coordination strategy for HAZMAT incidents. Ashoori et al (2014) analysed the social role and functional skills required by medical teams using team Worker Competencies Analysis. Although it was not possible to conduct a similar analysis for this study, the HAZMAT scenario from the Strategies Analysis was used for a functional analysis of team Worker Competencies Analysis for the traffic incident management system.…”

Section: Used a Strategies Analysismentioning

confidence: 99%

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A human factors investigation into the effectiveness of traffic incident management

Cattermole-Terzic¹

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Traffic incident management aims to maximise outcomes for road crash casualties and the safety of responders working at the scene, as well as optimising traffic flow past the incident and prompt restoration of full traffic capacity. Apart from improving road crash casualty outcomes, traffic incident management is also an important aspect of road safety because 14%-18% of all traffic incidents are secondary incidents occurring subsequent to a primary incident.Despite this, traffic incident management is relatively unexplored in research terms. The overall objective of this thesis was, therefore, to use an explorative approach to identify ways to improve traffic incident management.The first study aimed to better understand the primary safety concerns of responders at incidents. The study used interviews, focus groups, observations and surveys to explore operator perceptions of the safety and performance of their work environment. Results indicated that there were non-optimal technical issues at incidents for both responders and motorists. Non-technical issues in the work environment were also apparent and overall, responder perceptions of safety at traffic incidents was low. The findings from the first study guided further investigation of safety and performance issues at traffic incidents.In study two, a survey of 720 emergency responders was conducted to better understand the types of issues within traffic incident precincts. Technical issues identified through the survey were agency specific. Non-technical issues were consistent across all agencies and included poor inter-agency communication and poor understanding of the priorities and requirements of other agencies at incidents. The uniformity of non-technical issues across all agencies in study two directed the focus of the subsequent studies and also identified Naturalistic Decision Making as the most appropriate theory on which to base the remainder of the thesis.In the third study, the Critical Decision Method, decision ladder template and the Recognition-Primed Decision model were used to extract and map decisions made at incidents. The objectives of this study were to firstly extend these human factors tools into the traffic incident management domain; secondly, to identify system issues in the work environment; and thirdly to identify possible solutions to any identified system issues. The study identified that the Critical Decision Method was an effective knowledge elicitation tool for the analysis of responder decisions at traffic incidents, and that both the decision ladder 3 template and Recognition-Primed Decision model effectively identified system issues and corresponding solutions. Key issues identified at the scene related to inadequate technology, training and processes. The key recommendations to improve traffic incident management safety and performance included a requirement to develop an incident communication ability for all responders at the scene of large incidents, developing policies to support novice responders at their fir...

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Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit

Cited by 52 publications

References 35 publications

Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study

Work Domain Analysis for understanding medication safety in care homes in England: an exploratory study

Assessing the structure of non-routine decision processes in Airline Operations Control

A human factors investigation into the effectiveness of traffic incident management

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