Team Cognition in Handoffs: Relating System Factors, Team Cognition Functions and Outcomes in Two Handoff Processes
Year: 2022
Type: article
Abstract: Objective This study investigates how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU). We then seek to understand how the sociotechnical system and team cognition are related. Background Effective handoffs are critical to ensuring patient safety and have been the subject of many improvement efforts. However, the types of team-level cognitive processing during handoffs have not been explored, nor is it clear how the sociotechnical system shapes team cognition. Method We conducted this study in an academic, Level 1 trauma center in the Midwestern United States. Twenty-eight physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU) participated in semi-structured interviews. We performed qualitative content analysis and epistemic network analysis to understand the relationships between system factors, team cognition in handoffs and outcomes. Results Participants described three team cognition functions in handoffs—(1) information exchange, (2) assessment, and (3) planning and decision making; information exchange was mentioned most. Work system factors influenced team cognition. Inter-professional handoffs facilitated information exchange but included large teams with diverse backgrounds communicating, which can be inefficient. Intra-professional handoffs decreased team size and role diversity, which may simplify communication but increase information loss. Participants in inter-professional handoffs reflected on outcomes significantly more in relation to system factors and team cognition ( p < 0.001), while participants in intra-professional handoffs discussed handoffs as a task. Conclusion Handoffs include team cognition, which was influenced by work system design. Opportunities for handoff improvement include a flexibly standardized process and supportive tools/technologies. We recommend incorporating perspectives of the patient and family in future work.
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Science Foundation, John D. and Catherine T. MacArthur Foundation, University of Wisconsin-Madison, Georgia Clinical and Translational Science Alliance, National Institutes of Health, Agency for Healthcare Research and Quality, University of Illinois at Urbana-Champaign, Division of Graduate Education, National Center for Advancing Translational Sciences
Awards: Professional Practice Simulations for Engaging, Educating and Assessing Undergraduate Engineers, G1821963831, CAREER: Alternate Routes to Technology and Science, AutoMentor: Virtual Mentoring and Assessment in Computer Games for STEM Learning, Local Environmental Modeling: A Toolkit for Incorporating Place-Based Learning into Virtual Internships - A Scalable, Informal STEM Learning Environment, Assessing Complex Collaborative STEM Learning at Scale with Epistemic Network Analysis, DRK-12: Developing and Testing the Internship-inator, a Virtual Internship in STEM Authorware System, Using a Virtual Engineering Internship to Model the Complexity of Engineering Design Problems, TUES-Type 2: First-year Virtual Internships to Increase Persistence of Underrepresented Groups in Engineering: RescuShell and its Parent Company RescuTek, G7473568262, G761346317, EAGER Proposal for Research in Measurement and Modeling: Dynamic STEM Assessment through Epistemic Network Analysis, Measuring Complex STEM Thinking Using Epistemic Network Analysis, Collaborative Research: Research Initiation Grants in Engineering Education: Development of Innovation Capacity in Engineering Students Through Virtual Internships, G89454092, University of Wisconsin Institute for Clinical and Translational Research
OpenAlex ID: W4281779338