Evaluating collaborative features of critical care systems: A methodological study of information technology in surgical intensive care units

PURPOSE This study evaluates the collaborative features of a critical care system, CV, used in a surgical intensive care unit (SICU). In the evaluation, we take a socio-technical perspective--a view that the technical features of the system and social features of the work are fundamentally interrelated. METHODS We utilized qualitative data collection and analysis methods. We undertook seven months of observations and conducted more than thirty interviews of healthcare providers in the SICU. RESULTS We found that there are a wide variety of collaborative activities such as morning rounds and medication administration that a critical care system must support. We further found that CV supports healthcare providers by providing them awareness of others' activities. DISCUSSION We discuss the issue of awareness in greater detail. We also provide some recommendations on how to evaluate how well a system supports collaborative features such as multiple perspectives on information, workflow dependences, and context.

[1]  B. Buchanan,et al.  Expanding the concept of medical information: an observational study of physicians' information needs. , 1992, Computers and biomedical research, an international journal.

[2]  J. Baggs,et al.  Collaboration between nurses and physicians. , 1988, Image--the journal of nursing scholarship.

[3]  Madhu C. Reddy,et al.  Coordinating heterogeneous work: Information and representation in medical care , 2001, ECSCW.

[4]  Stephen M. Downs,et al.  Comparing user acceptance of a computer system in two pediatric offices: a qualitative study , 2000, AMIA.

[5]  Marc Berg,et al.  Considerations for sociotechnical design: experiences with an electronic patient record in a clinical context , 1998, Int. J. Medical Informatics.

[6]  Madhu C. Reddy,et al.  Collaborative information seeking: A field study of a multidisciplinary patient care team , 2008, Inf. Process. Manag..

[7]  B. Malinowski.  Baloma: The Spirits of the Dead in the Trobriand Islands , 2008 .

[8]  Bonnie Kaplan,et al.  Combining Qualitative and Quantitative Methods in Information Systems Research: A Case Study , 1988, MIS Q..

[9]  Marc Berg,et al.  Viewpoint Paper: Some Unintended Consequences of Information Technology in Health Care: The Nature of Patient Care Information System-related Errors , 2003, J. Am. Medical Informatics Assoc..

[10]  Gillian Symon,et al.  The coordination of work activities: Cooperation and conflict in a hospital context , 1996, Computer Supported Cooperative Work (CSCW).

[11]  Marc Berg,et al.  Patient care information systems and health care work: a sociotechnical approach , 1999, Int. J. Medical Informatics.

[12]  Wanda J. Orlikowski,et al.  Learning from Notes: organizational issues in groupware implementation , 1992, CSCW '92.

[13]  Lois M. L. Delcambre,et al.  Bundles in the Wild: Managing Information to Solve Problems and Maintain Situation Awareness , 2000, Libr. Trends.

[14]  Madhu C. Reddy,et al.  Technology, work, and information flows: Lessons from the implementation of a wireless alert pager system , 2005, J. Biomed. Informatics.

[15]  Carolyn E. Aydin,et al.  Survey Methods for Assessing Social Impacts of Computers in Healthcare Organizations , 2005 .

[16]  Dean F. Sittig,et al.  Lessons From “Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System” , 2006, Pediatrics.

[17]  Richard Bentley,et al.  Ethnographically-informed systems design for air traffic control , 1992, CSCW '92.

[18]  Johanna I. Westbrook,et al.  Research Paper: The Effect of Physicians' Long-term Use of CPOE on Their Test Management Work Practices , 2006, J. Am. Medical Informatics Assoc..

[19]  A. Strauss,et al.  Basics of qualitative research: Grounded theory procedures and techniques. , 1993 .

[20]  Mark S. Ackerman,et al.  Just talk to me: a field study of expertise location , 1998, CSCW '98.

[21]  R Beuscart,et al.  Dynamic workflow model for complex activity in intensive care unit. , 1998, Studies in health technology and informatics.

[22]  Bonnie Kaplan,et al.  Qualitative Research Methods for Evaluating Computer Information Systems , 2005 .

[23]  J. Lofland,et al.  Analyzing Social Settings , 1971 .

[24]  Paul Dourish,et al.  What we talk about when we talk about context , 2004, Personal and Ubiquitous Computing.

[25]  Paul Dourish,et al.  Awareness and coordination in shared workspaces , 1992, CSCW '92.

[26]  Madhu C. Reddy,et al.  A finger on the pulse: temporal rhythms and information seeking in medical work , 2002, CSCW '02.

[27]  M M Shabot.  The HP CareVue clinical information system , 1997, International journal of clinical monitoring and computing.

[28]  M M Shabot,et al.  Sociotechnical Requirements Analysis for Clinical Systems , 2003, Methods of Information in Medicine.

[29]  Marc Berg,et al.  Accumulating and Coordinating: Occasions for Information Technologies in Medical Work , 1999, Computer Supported Cooperative Work (CSCW).

[30]  Charlene R. Weir,et al.  Does user satisfaction relate to adoption behavior?: an exploratory analysis using CPRS implementation , 2000, AMIA.

[31]  P. Durieux,et al.  Impact of pharmacy validation in a computerized physician order entry context. , 2007, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[32]  M S Tuttle,et al.  The Physician's Information Assistant. , 1991, Proceedings. Symposium on Computer Applications in Medical Care.

[33]  Jakob E. Bardram,et al.  “I love the system—I just don't use it!” , 1997, GROUP.

[34]  R M Gardner,et al.  Impact of CPOE on Mortality Rates – Contradictory Findings, Important Messages , 2006, Methods of Information in Medicine.

[35]  Y. Han,et al.  Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System , 2005, Pediatrics.

[36]  Christian Heath,et al.  Documents and professional practice: “bad” organisational reasons for “good” clinical records , 1996, CSCW '96.

[37]  Wendy A. Kellogg,et al.  The adoption and use of BABBLE: A field study of chat in the workplace , 1999, ECSCW.

[38]  Joan S. Ash,et al.  Factors affecting the diffusion of the Computer-Based Patient Record , 1997, AMIA.

[39]  John Bowers,et al.  Workflow From Within and Without: Technology and Cooperative Work on the Print Industry Shopfloor , 1995, ECSCW.

[40]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[41]  J. Baggs,et al.  Intensive care unit use and collaboration between nurses and physicians. , 1989, Heart & lung : the journal of critical care.

[42]  C Safran,et al.  Meeting information needs: analysis of clinicians' use of an HIV database through an electronic medical record. , 1995, Medinfo. MEDINFO.

[43]  Kevin Crowston,et al.  The interdisciplinary study of coordination , 1994, CSUR.

[44]  C. Aydin,et al.  Evaluating Health Care Information Systems: Methods and Applications , 1993 .

[45]  Dave W. Randall,et al.  Ambiguities, Awareness and Economy: A Study of Emergency Service Work , 2004, Computer Supported Cooperative Work (CSCW).

[46]  Joan S. Ash,et al.  Report of conference Track 4: socio-technical issues of HIS , 2003, Int. J. Medical Informatics.

[47]  J H van Bemmel,et al.  Does an integrated medical workstation really help clinicians?--A formal user evaluation. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.