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Sketching Awareness: A Participatory Study to Elicit Designs for Supporting Ad Hoc Emergency Medical Teamwork

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Abstract

Prior CSCW research on awareness in clinical settings has mostly focused on higher-level team coordination spanning across longer-term trajectories at the department and inter-department levels. In this paper, we offer a perspective on what awareness means within the context of an ad hoc, time- and safety-critical medical setting by looking at teams treating severely ill patients with urgent needs. We report findings from four participatory design workshops conducted with emergency medicine clinicians at two regional emergency departments. Workshops were developed to elicit design ideas for information displays that support awareness in emergency medical situations. Through analysis of discussions and clinicians’ sketches of information displays, we identified five features of teamwork that can be used as a foundation for supporting awareness from the perspective of clinicians. Based on these findings, we contribute rich descriptions of four facets of awareness that teams manage during emergency medical situations: team member awareness, elapsed time awareness, teamwork-oriented and patient-driven task awareness, and overall progress awareness. We then discuss these four awareness types in relation to awareness facets found in the CSCW literature.

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References

  • Argote, L. (1982). Input Uncertainty and Organizational Coordination in Hospital Emergency Units. Administrative Science Quarterly, vol. 27, 3, pp. 420–434.

    Article  Google Scholar 

  • Bardram, Jacob E. (2000). Temporal Coordination – On Time and Coordination of Collaborative Activities at a Surgical Department. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 9, no. 2, May 2000, pp. 157–187.

  • Bardram, Jacob E., Thomas R. Hansen, and Mads Soegaard (2006). AwareMedia: A Shared Interactive Display Supporting Social, Temporal, and Spatial Awareness in Surgery. In S. Greenberg, G. Mark, S. Fussell, and K. Inkpen (eds): CSCW’06. Proceedings of the Conference on Computer-Supported Cooperative Work, Banff, Alberta, Canada, 4 – 8 November, 2006. New York: ACM Press, pp. 109–118.

  • Bergs, Engelbert A. G., Frans L. P. A. Rutten, Tamer Tadros, Pieta Krijnen, and Inger B. Schipper (2005). Communication during Trauma Resuscitation: Do We Know What is Happening? Injury, vol. 36, no. 8, August 2005, pp. 905–911.

  • Bitterman, Noemi (2006). Technologies and Solutions for Data Display in the Operating Room. Journal of Clinical Monitoring and Computing, vol. 20, no. 3, pp. 165–173.

    Article  Google Scholar 

  • Burd, Randall S. and Steven Elliot (2011). Evaluation, Stabilization and Initial Management After Multiple Trauma. In B. P. Fuhrman and J. J. Zimmerman (eds): Pediatric Critical Care. St. Louis, Mosby, Chapter 112.

    Google Scholar 

  • Cabitza, Federico, Marcello Sarini, and Carla Simone (2007). Providing Awareness through Situated Process Maps: The Hospital Care Case. In T. Gross and K. Inkpen (eds): Group’07. Proceedings of the International Conference on Support Group Work, Sanibel Island, FL, USA, 4 – 7 November, 2007. New York: ACM Press, pp. 41–50.

  • Cabitza, Federico, Carla Simone, and Marcello Sarini (2009a). Leveraging Coordinative Conventions to Promote Collaboration Awareness. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 18, no. 4, pp. 301–330.

    Article  Google Scholar 

  • Cabitza, Federico, Carla Simone, and Giovanni Zorzato (2009b). ProDoc: An Electronic Patient Record to Foster Process-Oriented Practices. In I. Wagner, H. Tellioglu, E. Balka, C. Simone, and L. Ciolfi (eds): ECSCW’09. Proceedings of the 11th European Conference on Computer Supported Cooperative Work, Vienna, Austria, 7 – 11 September, 2009. Springer London, pp. 85–104.

  • Carroll, John M. (2000). Five Reasons for Scenario-Based Design. Interacting with Computers, vol. 13, no. 1, pp. 43–60.

    Article  Google Scholar 

  • Carroll, John M., Dennis C. Neale, Philip L. Isenhour, Mary Beth Rosson, D. Scott McCrickard (2003). Notification and Awareness: Synchronizing Task-Oriented Collaborative Activity. International Journal of Human-Computer Studies, vol. 58, no. 5, pp. 605–632.

    Article  Google Scholar 

  • Carroll, John M., Marry Beth Rosson, Gregorio Convertino, and Craig H. Ganoe (2006). Awareness and Teamwork in Computer-Supported Collaborations. Interacting with Computers, vol. 18, no. 1, pp. 21–46.

    Article  Google Scholar 

  • Carroll, John M., Marry Beth Rosson, Umer Farooq, and Lu Xiao (2009). Beyond Being Aware. Information and Organization, vol. 19, no. 3, 162–185.

    Article  Google Scholar 

  • Coiera, Enrico (2000). When Conversation is Better Than Computation. Journal of the American Medical Informatics Association, vol. 7, no. 3, pp. 277–286.

    Article  Google Scholar 

  • Corbin, Juliet and Anselm Strauss (2008). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, Sage Publications Inc.

    Google Scholar 

  • Dourish, Paul and Victoria Bellotti (1992). Awareness and Coordination in Shared Workspaces. In M. Mantel and R. Baecker (eds): CSCW’92. Proceedings of the Conference on Computer-Supported Cooperative Work, Toronto, ON, Canada, 1 – 4 November 1992. New York: ACM Press, pp. 107–114.

  • Drews, Frank A. and Dwayne R. Westenskow (2006). The Right Picture is Worth a Thousand Numbers: Data Displays in Anesthesia. Human Factors: The Journal of the Human Factors and Ergonomics Society, vol. 48, no. 1, pp. 59–71.

    Article  Google Scholar 

  • Endsley, Mica R. (1995). Toward a Theory of Situation Awareness in Dynamic Systems. Human Factors: The Journal of the Human Factors and Ergonomics Society, vol. 37, no. 1, pp. 32–64.

    Article  Google Scholar 

  • Faraj, Samer and Yan Xiao (2006). Coordination in Fast-Response Organizations. Management Science, vol. 52, no. 8, pp. 1155–1169.

    Article  Google Scholar 

  • Fitzpatrick, Geraldine and Gunnar Ellingsen (2013). A Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 22, nos. 4–6, pp. 609–665.

    Article  Google Scholar 

  • Gross, Tom (2013). Supporting Effortless Coordination: 25 Years of Awareness Research. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 22, nos. 4–6, pp. 425–474.

    Article  Google Scholar 

  • Gutwin, Carl and Saul Greenberg (2002). Descriptive Framework of Workspace Awareness for Real-Time Groupware. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 11, nos. 3–4, pp. 411–446.

    Article  Google Scholar 

  • Heath, Christian, Marcus Sanchez Svensson, Jon Hindmarsh, Paul Luff, Dirk vom Lehn (2002). Configuring Awareness. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 11, nos. 3–4, pp. 317–347.

    Article  Google Scholar 

  • Kolfschoten, Gwendolyn L., Thomas Herrmann, and Stephen Lukosch (2013). Differentiated Awareness-Support in Computer Supported Collaborative Work. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 22, nos. 2–3, pp. 107–112.

    Article  Google Scholar 

  • Kusunoki, Diana S., Aleksandra Sarcevic, Zhan Zhang, and Randall S. Burd (2013). Understanding Visual Attention of Teams in Dynamic Medical Settings through Vital Signs Monitor Use. In C. Lampe and L. Terveen (eds): CSCW’13. Proceedings of the Conference on Computer-Supported Cooperative Work, San Antonio, Texas, USA, 23 – 27 February, 2013. New York: ACM Press, pp. 527–540.

  • Lee, Soyoung, Charlotte Tang, Sun Young Park, and Yunan Chen (2012). Loosely Formed Patient Care Teams: Communication Challenges and Technology Design. In J. Grudin, G. Mark, and J. Riedl (eds): CSCW’12. Proceedings of the Conference on Computer-Supported Cooperative Work, Seattle, Washington, USA, 11 – 15 February, 2012. New York: ACM Press, pp. 867–876.

  • Ludwig, Stephen and Jane M. Lavelle (2010). Resuscitation – Pediatric Basic and Advanced Life Support. In G. R. Fleisher and S. Ludwig (eds): Textbook of Pediatric Emergency Medicine. Philadelphia Lippincott Williams & Wilkins, Chapter 1.

    Google Scholar 

  • Majchrzak, Ann, Philip H. B. More, and Samer Faraj (2012). Transcending Knowledge Differences in Cross-Functional Teams. Organization Science, vol. 23, no. 4., pp. 951–970.

    Article  Google Scholar 

  • Muller, M. J. (1993). PICTIVE: Democratizing the Dynamics of the Design Session. In D. Schuler and A. Namioka (eds): Participatory Design: Principles and Practices. Hillsdale, Erlbaum Associates Inc., pp. 211–239.

    Google Scholar 

  • Muller, Michael J. and Allison Druin (2012). Participatory Design: The Third Space in Human-Computer Interaction. In J. A. Jacko (ed): The Human-Computer Interaction Handbook. Boca Raton CRC Press, pp. 1125–1153.

    Chapter  Google Scholar 

  • Parush, Avi, Chelsea Kramer, Tara Foster-Hunt, Kathryn Momtahan, Aren Hunter, and Benjamin Sohmer (2011). Communication and Team Situation Awareness in the OR: Implications for Augmentative Information Display. Journal of Biomedical Informatics, vol. 44, no. 3, pp. 477–485.

    Article  Google Scholar 

  • Pratt, Wanda, Madhu C. Reddy, David W. McDonald, Peter Tarczy-Hornoch, and John H. Gennari (2004). Incorporating Ideas from Computer-Supported Cooperative Work. Journal of Biomedical Informatics, vol. 32, no. 2, pp. 128–137.

    Article  Google Scholar 

  • Prinz, Wolfgang (1999). NESSIE: An Awareness Environment for Cooperative Settings. In S. Bodker, M. Kyng, and K. Schmidt (eds): ECSCW’99. Proceedings of the Sixth European Conference on Computer Supported Cooperative Work, Copenhagen, Denmark, 12 – 16 September 1999. Kluwer Academic Publishers, pp. 391–410.

  • Randell, Rebecca, Stephanie Wilson, and Peter Woodward (2011). Variations and Commonalities in Processes of Collaboration: The Need for Multi-Site Workplace Studies. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 20, nos. 1–2, pp. 37–59.

    Article  Google Scholar 

  • Reddy, Madhu C. and Paul, Dourish (2002). A Finger on the Pulse: Temporal Rhythms on Information Seeking in Medical Work. In C. Neuwirth and T. Rodden (eds): CSCW’02. Proceedings of the Conference on Computer-Supported Cooperative Work, New Orleans, LA, USA, 16 – 20 November, 2002. New York: ACM Press, pp. 344–353.

  • Reddy, Madhu C., Paul Dourish, and Wanda Pratt (2006). Temporality in Medical Work: Time Also Matters. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 15, no. 1, pp. 29–53.

    Article  Google Scholar 

  • Salmon, Paul M., Neville A. Stanton, Daniel P. Jenkins, Guy H. Walker, Mark S. Young, and Amardeep Aujla (2007). What Really is Going On? Review, Critique and Extension of Situation Awareness Theory. Engineering Psychology and Cognitive Ergonomics, vol. 4562, pp. 407–416.

    Article  Google Scholar 

  • Sarcevic, Aleksandra (2010). Who’s Scribing? Documenting Patient Encounter during Trauma Resuscitation. In G. Fitzpatrick, S. Hudson, K. Edwards, and T. Rodden (eds): CHI’10. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, Atlanta, GA, USA, 10 – 15 April, 2010. New York: ACM Press, pp. 1899–1908.

  • Sarcevic, Aleksandra and Randall S. Burd (2008). What’s the Story? Information Needs of Trauma Teams. AMIA’08. Proceedings of the American Medical Informatics Association Annual Symposium, Washington, DC, USA, 8 – 12 November, 2008, pp. 641–645.

  • Sarcevic, Aleksandra and Randall S. Burd (2009). Information Handover in Time-Critical Work. In W. Prinz and W. Lutters (eds): Group’09. Proceedings of the International Conference on Support Group Work, Sanibel Island, FL, USA, 10 – 13 May, 2009. New York: ACM Press, pp. 301–310.

  • Sarcevic, Aleksandra, Leysia A. Palen, and Randall S. Burd (2011b). Coordinating Time-Critical Work with Role-Tagging. In J. Bardram and N. Ducheneaut (eds): CSCW’11. Proceedings of the Conference on Computer-Supported Cooperative Work, Hangzhou, China, 19 – 23 March, 2011. New York: ACM Press, pp. 465–474.

  • Sarcevic, Aleksandra, Ivan Marsic, Lauren J. Waterhouse, David C. Stockwell, and Randall S. Burd (2011a). Leadership Structures in Dynamic, Critical Care Settings: A Study of Two Trauma Centers. International Journal of Medical Informatics, vol. 80, no. 4, pp. 227–238.

    Article  Google Scholar 

  • Sarcevic, Aleksandra, Ivan Marsic, and Randall S. Burd (2012). Teamwork errors in trauma resuscitation. ACM Transactions on Computer-Human Interaction (TOCHI), vol. 19, no. 2, July 2012, article 13.

  • Schmidt, Kjeld (2002). The Problem with ‘Awareness’: Introductory Remarks on ‘Awareness in CSCW’. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 11, nos. 3–4, pp. 285–298.

    Article  Google Scholar 

  • Schmidt, Kjeld and Liam Bannon (1992). Taking CSCW Seriously. Computer Supported Cooperative Work (CSCW): An International Journal, vol. 1, nos. 1–2, pp. 7–40.

    Article  Google Scholar 

  • Tjora, Aksel Hagen and Graham Scambler (2009). Square Pegs in Round Holes: Information Systems, Hospitals, and the Significance of Contextual Awareness. Social Science & Medicine, vol. 68, no. 3, pp. 519–525.

    Article  Google Scholar 

  • Wears, Robert L., Shawna J. Perry, Stephanie Wilson, Julia Galliers, and James Fone (2007). Emergency Department Status Boards: User-Evolved Artefacts for Inter- and Intra-Group Coordination. Cognition, Technology and Work, vol. 9, no. 3, pp. 163–170.

    Article  Google Scholar 

  • Wu, Leslie, Jesse Cirimele, Jonathan Bassen, Kristen Leach, Stuart Card, Larry Chu, Kyle Harrison, and Scott Klemmer (2013). Head-Mounted and Multi-Surface Displays Support Emergency Medical Teams. In C. Lampe and L. Terveen (eds): CSCW’13. Proceedings Companion of the Conference on Computer-Supported Cooperative Work, San Antonio, TX, USA, 23 – 27 February, 2013. New York: ACM Press, pp. 279–282.

  • Wulf, Volker, Markus Rohde, Volkmar Pipek, and Gunnar Stevens (2011). Engaging with Practices: Design Case studies as a Research Framework in CSCW. In J. Bardram and N. Ducheneaut (eds): CSCW’11. Proceedings of the Conference on Computer-Supported Cooperative Work, Hangzhou, China, 19 – 23 March, 2011. New York: ACM Press, pp. 505–512.

  • Xiao, Yan, Jacob F. Seagull, Colin F. Mackenzie, and Katherine Klein (2004). Adaptive Leadership in Trauma Resuscitation Teams: A Grounded Theory Approach to Video Analysis. Cognition, Technology & Work, vol. 6, no. 3, pp. 158–164.

    Google Scholar 

  • Xiao, Yan, Young-Ju Kim, Sharyn D. Gardner, Samer Faraj, and Colin F. MacKenzie (2006). Communication Technology in Trauma Centers: A National Survey. The Journal of Emergency Medicine, vol. 30, no. 1, pp. 21–28.

    Article  Google Scholar 

  • Xiao, Yan, Stephen Schenkel, Samer Faraj, Colin F. MacKenzie, and Jacqueline Moss (2007). What Whiteboards in a Trauma Center Operating Suite Can Teach Us About Emergency Department Communication. Annals of Emergency Medicine, vol. 50, no. 4, pp. 387–395.

    Article  Google Scholar 

  • Yun, Seokhwa, Samer Faraj, and Henry P. Sims (2005). Contingent Leadership and Effectiveness of Trauma Resuscitation Teams. Journal of Applied Psychology, vol. 90, no. 6, pp. 1288–1296.

    Article  Google Scholar 

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Acknowledgments

This work is supported by the National Science Foundation under Grant No. #1253285, and partially supported by the National Library of Medicine of the National Institutes of Health under Award No. R21LM011320-01A1. We thank Randall S. Burd, MD, PhD, and Sage R. Myers, MD for their support, as well as to the medical staff at the research sites for their participation. Thanks also to Michael Muller for his valuable feedback on earlier versions of this manuscript. Finally, thanks to the anonymous reviewers for their suggestions and recommendations.

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  1. College of Computing and Informatics, Drexel University, 3141 Chestnut Street, 19104, Philadelphia, PA, USA

    Diana Kusunoki, Aleksandra Sarcevic, Zhan Zhang & Maria Yala

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  1. Diana Kusunoki
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  2. Aleksandra Sarcevic
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  3. Zhan Zhang
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Correspondence to Aleksandra Sarcevic.

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Kusunoki, D., Sarcevic, A., Zhang, Z. et al. Sketching Awareness: A Participatory Study to Elicit Designs for Supporting Ad Hoc Emergency Medical Teamwork. Comput Supported Coop Work 24, 1–38 (2015). https://doi.org/10.1007/s10606-014-9210-5

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