Abstract
This study examines an Emergency Medical Service in order to analyze the composite set of activities and instruments directed at locating the patient. The good management of information about the location of the emergency is highly relevant for a reliable rescue service, but this information depends on knowledge of the territory that is socially distributed between EMS operators and callers. Accordingly, the decision-making process often has to go beyond the emergency service protocols, engaging the operator in undertaking an open negotiation in order to transform the caller’s role from layman to “co-worker”. The patient’s location turns out to be an emerging phenomenon, collaborative work based on knowledge management involving two communities—the callers and the EMS operators—that overlap partially. Drawing examples from emergency calls, the study analyzes the practice of locating a patient as a complex and multi-layered process, highlighting the role played by new and old technologies (the information system and the paper maps) in this activity. We argue that CSCW technologies enable the blended use of different kinds of instruments and support an original interconnection between the professional localization systems and the public’s way of defining a position.
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Notes
This definition echoes a similar distinction proposed by the environmental psychology between “survey” (abstract understanding of the spatial relationships between locations) and “route” (the personal knowledge of places or landmarks and the routes that connect them). See Münzer et al. 2006; Tversky 1993.
References
Artman, H., & Waern, Y. (1999). Distributed cognition in an emergency co-ordination center. Cognition, Technology and Work, vol.1.
Atkinson, P., Coffey, A., & Delamont, S. (Eds.). (2001). Handbook of ethnography. London: Sage.
Barthes, R. (1970). L’empire des signes. Paris: Skira.
Bentley, R., Hughes, J. A., Randall, D., Rodden, T., Sawyer, P., Shapiro, D., et al. (1992). Ethnographically-informed systems design for air traffic control. In J. Turner, & R. Kraut (eds), CSCW ’92. Proceedings of the conference on computer supported cooperative work, Toronto, Canada, October 31 to November 4, 1992. New York: ACM Press, pp. 123–129.
Bernini, G. (1994). La banca dati del ‘progetto di Pavia’ sull’italiano lingua seconda. Studi Italiani di Linguistica Teorica e Applicata, 23(2), 221–236.
Beynon-Davies, P. (1999). Human error and information system failure: the case of the London Ambulance service computer-aided despatch system project. Interacting with Computers, 11, 699–720.
Bloor, M. (2001). The ethnography of healt and medicine. In P. Atkinson, A. Coffey, & S. Delamont (Eds.), Handbook of ethnography. London: Sage.
Boden, D., & Zimmerman, D. H. (Eds.). (1991). Talk and social studies in ethnomethodology and conversation analysis. Cambridge: Polity.
Bowers, J. M., Martin, D. (1999). Informing collaborative information visualization through an ethnography of ambulance control. In Bødker S., M. Kyng, & K. Schmidt (Eds.), ECSCW’99 Proceedings of the sixth conference on Computer Supported Cooperative Work, Copenhagen, Denmark, September 12–16, 1999. Netherlands: Kluwer Academic Publishers, pp 309–330.
Dourish, P. (2001). Where the action is: the foundations of embodied interaction. Cambridge: MIT.
Dourish, P. (2004). What we talk about when we talk about context. Personal and Ubiquitous Computing, 8(1), 19–24. Springer-Verlag.
Dovigo, F. (2004). Abitare la salute. Franco Angeli: Milano.
Dovigo, F., & Redaelli, I. (2007). Ordinarie emergenze. Milano, Guerini Scientifica.
Duranti, A. (1992). Etnografia del parlare quotidiano. Carocci: Roma.
Earl, M. (2001). Knowledge management strategies: toward a taxonomy. Journal of Management Information System, 18(1), 215–233.
Engeström, Y., & Middleton, D. (Eds.). (1996). Cognition and communication at work. Cambridge: Cambridge University Press.
Finkelstein, A., Dowell, J. (1996). A comedy of errors: the London ambulance service case study. In Proc. 8th International Workshop on Software Specifications & Design IWSSD-8, Los Alamitos, IEEE Computer Society Press, pp. 2–4.
Fitch, K. L., & Sanders, R. E. (Eds.). (2005). Handbook of language and social interaction. Mahwah: Lawrence Erlbaum Associates.
Fitzgerald, G., & Russo, N. L. (2005). The turnaround of the London ambulance service computer-aided despatch system (Lascad). European Journal of Information System, 14(3), 244–257.
Fitzpatrick, G. (2003). Emergent expertise sharing in a new community. In M. Ackermann, V. Pipek, & V. Wulf (Eds.), Sharing expertise: beyond knowledge management (pp. 81–106). Cambridge: MIT Press.
Foucault, M. (1998). Eterotopie. In A. Pandolfi (Ed.), Archivio Foucault. Interventi, colloqui, interviste, vol. 3, 1978–85, Estetica dell’esistenza, etica, politica. Milano: Feltrinelli.
Garfinkel, H. (1967). Studies in etnomethodology. Prentice-Hall: Englewoods Cliffs.
Goodwin, C. (1994). Professional vision. American Anthropologist, 96(3), 606–633.
Goodwin, C. (2000). Action and embodied within situated human interaction. Journal of Pragmatics, 32, 1489–1522.
Goodwin, C., & Goodwin, M. H. (1996). Seeing as situated activity: formulating planes. In Y. Engeström & D. Middleton (Eds.), Cognition and communication at work. Cambridge: Cambridge University Press.
Groth, K. (2004). Knowing who knows—an alternative approach to knowledge management, PhD Thesis, Department of Numerical Analysis and Computing Science, Royal Institute of Technology, Stockholm.
Groth, K., & Bowers, J. (2001). On finding things out: situating organizational knowledge, ECSCW’01, Proceedings of the Seventh European Conference on Computer-Supported Cooperative Work, 16–20 September 2001, Bonn, Germany. Netherland: Kluwer Academic Publishers, pp. 259–278.
Heath, C., & Luff, P. (1992). Collaboration and control: crisis management and multimedia technology in London underground line control rooms. Computer Supported Cooperative Work (CSCW), 1, 69–94.
Heath, C., & Luff, P. (2000). Tecnology in action. Cambridge: Cambridge University Press.
Hutchins, E. (2005). Material anchors for conceptual blends. Journal of Pragmatics, 37, 1555–1577.
Landgren, J. (2005). Supporting fire crew sensemaking enroute to incidents. International Journal of Emergency Management, 2(3), 176–188.
Luff, P., Gilbert, N., & Frohlich, D. (1990). Computer and conversation. London: Academic.
Luff, P., Hindmarsh, J., & Heath, C. (2000). Workplace studies. Recovering work practice and informing system design. Cambridge: Cambridge University Press.
Martin, D., Bowers, J., & Wastell, D. (1997). The interactional affordances of technology: an ethnography of human-computer interaction in an ambulance control centre. In People and Computers XII, Proceedings of HCI'97 (Cambridge).
Martin, D., O’Neill, J., Randall, D., & Rouncefield, M. (2007). How can I help you? Call centres, classification work and coordination. Computer Supported Cooperative Work, 16, 231–264.
McCarthy, J., Wright, P., & Cooke, M. (2004). From information processing to dialogical meaning making. Cognition, Technology and Work, 6, 107–116.
Münzer, S., Zimmer, H. D., Schwalm, M., Baus, J., & Aslan, I. (2006). Computer-assisted navigation and the acquisition of route and survey knowledge. Journal of Environmental Psychology, 26(4), 300–308.
Normark, M., & Randall, D. (2005). Local expertise at an emergency call center, ECSCW’05 Proceedings of the European Conference on Computer Supported Cooperative Work, Paris, France, 18–22 September 2005, Netherlands, Springer, pp. 247–366.
Paoletti, I. (2009). Communication and diagnostic work in medical emergency calls in Italy. Computer Supported Cooperative Work, 18, 229–250. doi:10.1007/s10606-009-9091-1.
Pettersson, M., Randall, D., & Helgeson, B. (2004). Ambiguities, awareness and economy: a study of emergency service work. Computer Supported Cooperative Work, 13, 125–154.
Randall, D., O’Brien, J., Rouncefield, M., & J. A. Hughes (1996). Organzational memory and CSCW, conference on HCI (OzCHI ’96), Supporting the ‘Mavis’ Phenomenon. Proceedings of the Sixth Australian Conference on Computer-Human Interaction, 24–27 November 1996, Hamilton, New Zealand, Los Alamitos, California, IEEE Computer Society Press, pp. 26–34.
Suchman, L. (1997). Centers of coordination: a case and some themes. In L. B. Resnick, R. Säljö, C. Pontecorvo, & B. Burge (Eds.), Discourse, tools and reasoning: essays on situated cognition. Berlin: Springer.
Suchman, L. (2007). Human-machine reconfigurations: plans and situated actions. New York: Cambridge University Press.
Tjora, A. H. (2001). The tecnological mediation of the nursing-medical boundary. Sociology of Healt & Illness, 22(69), 721–741.
Tracy, K. (1997). Interactional trouble in emergency services request: a problem of frames. Research on Language and Social Interaction, vol.30(4), pp.315–343. doi:10.1207/s15327973rlsi3004_3.
Turner, B., & Pidgeon, N. (1997). Man-made disasters. Boston: Butterworth-Heinemann.
Tversky, B. (1993) Cognitive maps, cognitive collages, and spatial mental models. In: A. U. Frank, & I. Campari (Eds.), COSIT'93, Lecture Notes in Computer Science 716, 14–24. Springer, Berlin.
Wakin, M. A., & Zimmerman, D. H. (1999). Reduction and specialization in emergency and directory assistance calls. Research on Language and Social Interaction, 32(4), 409–437. doi:10.1207/S15327973rls3204_4.
Wenger, E. (1998). Communities of practice. Learning, Meaning and identity. Cambridge: Cambridge University Press.
Wenger, E. (2000). Communities of practice and learning systems. Organizations, 7(2), 225–246.
Whalen, M. R., & Zimmerman, D. H. (1987). Sequential and institutional contexts in calls for help. Social Psycology Quaterly, 50(2), 172–185. doi:10.2307/2786750.
Whalen, J., & Zimmerman, D. H. (2005). Working a call. Multiparty management and interactional infrastructure. In C. D. Baker, M. Emmison, & A. Firth (Eds.), Calling for help. Language and social interaction in telephone helplines. Amsterdam: John Benjamins.
Zimmerman, D. H. (1992a). The interactional organization of calls for emergency assistance. In P. Drew & J. Heritage (Eds.), Talk at work (pp. 418–469). Cambridge University Press: Cambridge.
Zimmerman, D. H. (1992b). Achieving context. Openings in emergency calls. In G. Watson & R. M. Seiler (Eds.), Text in context (pp. 35–51). Newbury Park: Sage.
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Appendix
Appendix
Transcription of calls n.1 and 2 of case n.15. (original language). The transcriptional convention derives from “La banca dati del “Progetto di Pavia” sull’italiano lingua seconda” (Bernini 1994)
Call n. 1 (1’20”): C\ chiamante; I\ infermiere di centrale operativa; V\ volontario del soccorso sul territorio | |
1. | \I\ centodiciotto |
2. | \C\ senta telefono da- O. C’è_ qui_ mio_ cugino_ A._ di_ cinquant’_anni che si è/sta male. Si è sdraiato &sul divano& |
3. | \I\ &O.& in che via signora?& |
4. | \C\ O. noi siamo in basso. Avete presente l’ombrellificio= |
5. | \I\ no mi deve dare la via |
6. | \C\ sì se voi venite all’ombrellificio B._sapete_ dov’è_ l’_ombrellificio_ B.? |
7. | \I\ !no! non arrivo io da L. signora |
8. | \C\ a ecco |
9. | \I\ le mando l’ambulanza della zona |
10. | \C\ !sì appunto! Dica lì, sopra il cortile. Io mi faccio trovare/ quando prende la strada no, per venire= |
11. | \I\ = signora ascolti una cosa, ci sarà una via no? |
12. | \C\ !via B.! |
13. | \I\ ok |
14. | \C\ ma non è conosciuta |
15. | \I\ !fa niente! Lei mi dia la via &perché& |
16. | \C\ &via B.& |
17. | \I\ è inutile che lo spiega a me |
18. | \C\ numero ventuno però se dice adesso all’ambulanza |
19. | \I\ sì |
20. | \C\ che ci facciamo trovare !sulla strada!, all’imbocco della strada che sale per O. |
21. | \I\ sì |
22. | \C\ noi_ ci_ facciamo_ trovare_ e_ lo_ accompagnamo_ perché_ è_ una_ via_ un_ po’_ fuori |
23. | \I\ sì, va bene, quello va bene però |
24. | \C\ sì |
25. | \I\ almeno_ per_ avere_ un_ punto_ di_ riferimento |
26. | \C\ sì_ sì, via B. |
27. | \I\ la via/ il_ il nome della famiglia |
28. | \C\ B.E. |
29. | \I\ B. E’ uno che soffre già di qualcosa? |
30. | \C\ no_ no_ no_ no_ no. |
31. | \I\ e’ sano |
32. | \C\ sano_ sì |
33. | \I\ adesso si è sentito male? |
34. | \C\ si sta sentendo male |
35. | \I\ &è sveglio però^& |
36. | \C\ &no_ no_no (XX)& sta sudando |
37. | \I\ va bene glielo mando subito, grazie_buongiorno |
38. | \C\ salve. Allora ha capito bene? O. |
49. | \I\ sì, al limite ho il numero di telefono_ signora_ se_ rimane_ qualcuno- |
40. | \C\ sì |
41. | \I\ a casa |
42. | \C\ sì, io |
43. | \I\ va bene, grazie |
44. | \C\ un po’ in fretta eh^ |
Call n. 2 (40”) | |
1. | \V\ C. ?[risponde dicendo il nome del paese in cui ha sede l’associazione del soccorso] |
2. | \I\ sì_ ciao_ mi_ vai_ per_ cortesia a [+] O. m’ha detto che la via si chiama via B. |
3. | \V\ via B. |
4. | \I\ ha detto che è una via difficile da raggiungere nel senso che O. giù in basso dove c’è l’ombrellificio B., &qualcosa del genere& |
5. | \V\ &ah in fondo, si ho capito&= |
6. | \I\ = ecco. Arriva anche il medico un uomo di cinquant’anni, nulla in anamnesi adesso malore improvviso, svenimento, pallido, sudatissimo |
7. | \V\ &giallo?& |
8. | \I\ &ti mando anche il medico& |
9. | \V\ va bene |
10. | \I\ è un giallo_rosso |
11. | \V\ giallo_rosso? |
12. | \I\ sì, ciao |
Call n.1:; C\ caller; O\ Operator (registered nurse); V\Volunteer | |
1. | O\ 118 |
2. | C\ I’m calling from O. [the village name]. My cousin A., fifty years old, doesn’t feel very well. He is lying down on the sofa |
3. | O\ Oh, what is the name of the street? |
4. | C\ Oh, we are in the lower part [of the village]. Do you know the umbrella factory? |
5. | O\ No, you have to tell me the street name |
6. | C\ Yes, if you come to the umbrella factory. Do you know where B.’ s factory is? |
7. | O\ No, I’m not coming to you from Lecco madam |
8. | C\ I know |
9. | O\ I’m sending you a local ambulance |
10. | C\ Yes, ok. Tell them above the courtyard. I will be there. When you take the road to come |
11. | O\ Madam, listen to me. There is a name for that street, isn’t there? |
12. | C\ B. street! |
13. | O\ Ok |
14. | C\ But no-one knows it |
15. | O\ It doesn’t matter. You have to tell me the name because |
16. | C\ B. street |
17. | O\ you don’t have to explain to me |
18. | C\ Number twenty-one but call for the ambulance now, please |
19. | O\ Yes |
20. | C\ We’ll be on the road, at the entrance of the road that ascent to O. |
21. | O\ Ok |
22. | C\ We’ll meet on the road and I’ll go with you because it’s a out of the way |
23. | O\ Ok, good, all right but |
24. | C\ Yes |
25. | O\ Is there at least a reference point |
26. | C\ Yes, Yes, street B. |
27. | O\ The street, the family name |
28. | C\ B.E. |
29. | O\ B.E. does he already have some illness? |
30. | C\ No, no, no, no |
31. | O\ He’s healthy |
32. | C\ Yes, he is healthy |
33. | O\ And now he feels ill? |
34. | C\ He is ill now |
35. | O\ Is he awake? |
36. | C\ No, no, no he is sweating |
37. | O\ Ok, I send you someone immediately. Thank you, good morning |
38. | C\ Hi. So have you understand? O. |
39. | O\ Yes, at least I have your telephone number too if someone stays |
40. | C\ Yes |
41. | O\ At home |
42. | C\ Yes, I’ll stay |
43. | O\ Ok, thank you |
44. | C\ Quikly |
Call n. 2 | |
1. | V\ C.? [The volunteer responded by saying the village name of the assistance association headquarters] |
2. | O\ Hello, please go to O. The caller told me that the street name is B. |
3. | V\ B. street |
4. | O\ She told me that is an unknown street. In O., in the southern part, where there is the B.’s umbrellas factory, something like that |
5. | V\ Yes, at the end...I’ve understood |
6. | O\ The doctor is arriving too, a man fifty years old, with nothing in particular in his case history now he suddenly feels ill, he fainted, he is pale and is sweating |
7. | V\ Yellow? |
8. | O\ I’m sending a doctor too |
9. | V\ All right |
10. | O\ It’s a yellow red |
11. | V\ Yellow red? |
12. | O\ yes, Bye |
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Dovigo, F., Redaelli, I. Knowledge Management in Locating the Patient in an Emergency Medical Service in Italy. Comput Supported Coop Work 19, 457–481 (2010). https://doi.org/10.1007/s10606-010-9118-7
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DOI: https://doi.org/10.1007/s10606-010-9118-7