Year: 2004
Type: article
Abstract: Crafting Information Technology Solutions, Not Experiments, for the Emergency DepartmentMuch of the cognitive activity in complex, highhazard, high-tempo work settings such as air traffic control, military operations, and acute health care is concerned with the anticipation of future requirements, prediction of deadlocks, reaction to evolving situations, and reallocation of resources.These complex cognitive activities are difficult to study because they involve deep domain knowledge.They also require a detailed understanding of the myriad local details and contingencies that offer and limit opportunities for action.This has particular import for the emergency department (ED) as one of the most complex, uncertain, and variable settings in health care.Many EDs are under increasing pressure to accommodate patients for longer periods and to perform more complex therapeutic and diagnostic interventions in order to compensate for resource limitations elsewhere in the facility.1,2 This imposes new demands on ED team members to coordinate greater patient workloads and to use resources efficiently.The planning and management of unit-level activities in health care involve what has been referred to as technical work.To support the cognitive load of technical work, acute care practitioners, including ED staff, have developed physical cognitive artifacts 3 including status boards, schedules, and checklists to capture, use, and convey information.These artifacts support a distributed cognition, 4 which is a ''commonly shared knowledge that benefits a group but cannot be known by any single individual.''Figure 1 describes both the individual and social senses of distributed cognition as well as the multiple roles that cognitive artifacts play.The development and use of cognitive artifacts make it possible to perform the otherwise impossible process of care coordination for the ED patient population.As the patient length of stay and the number of procedures increase in the ED, the need for more powerful cognitive artifacts also grows in order to support increased demands for patient care coordination.As the use of information technology (IT) grows in the ED community, it may help to be aware of potential difficulties as well as an approach that promises to assist new digital artifact development. HOW TECHNOLOGY MAY AND MAY NOT WORKPressure is strong to adopt new IT in the interest of improvements to ED work environment efficiency and
Source: Academic Emergency Medicine
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1996580234