Frontiers of Engineering Reports on Leading-Edge Engineering from the 2008 Symposium (2009) / Chapter Skim
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Cognitive Engineering Applications in Health Care--Ann M. Bisantz
Cognitive Engineering Applications in Health Care--Ann M. Bisantz
Pages 111-122
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From page 111... ...
. In the health care environment, individuals interact with a variety of information sources and technologies, ranging from handwritten charts to pagers and phones to electronic medical records and digital imaging systems.
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From page 112... ...
Cognitive engineering research in health care environments, which has a general goal of supporting safe and effective performance, has followed different research paths, including (1) characterizing complexities in the environment and demands on practitioners, sometimes with a focus on preventing medical errors; and (2)
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From page 113... ...
Audiotaped and face-to-face communications led to different strategies. For instance, if the information was audiotaped, incoming staff could not directly question outgoing staff; however, incoming nurses tended to listen to audiotaped information as a group and talk about the status of patients, which could result in a shared awareness of patient states and team coordination to meet patients' needs.
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From page 114... ...
Unanticipated effects included fewer physician reviews of current medications, because it was more difficult for them to access information in the computerized system than in the old paper record; and nurses feeling pressured to administer medication "on time," even when other higher priority tasks were necessary (both of which increased the chances of adverse events)
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From page 115... ...
. The paper form also supported work because it was portable, grouped information in ways that allowed comparisons to be made easily, allowed flexible annotations to accommodate unique circumstances, and allowed data to be represented in familiar notation.
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From page 116... ...
, support automated recording keeping and reporting, and allow information to be accessed at different locations in the hospital, but they also impose new constraints. The ability to add or change information is limited by available computer terminals, which typically require sign-on sequences; the form of information is limited to the characters or icons available on a keyboard or through the interface, and local methods of encoding are often lost; and the length and placement of entries is prescribed (e.g., free-form annotations cannot be added)
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From page 117... ...
Source: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2008. Reprinted with permission.
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From page 118... ...
For instance, a limited number of entries were visible in the column showing treatment plans, and providers could no longer use hand-drawn checkboxes to indicate progress. Because it was more difficult for providers to document and track patient progress, some providers resorted to carrying notes; this supported the work of individual providers, but the information was no longer publicly available, thus decreasing support for coordination among caregivers.
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From page 119... ...
To meet those needs, we must first understand the complexities faced by health care workers and the knowledge, strategies, and tools they use. Cognitive engineering provides methods and tools for developing and implementing new technologies for this environment.
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From page 120... ...
2008. A Cognitive Work Analysis of Cardiac Care Nurses Performing Teletriage.
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2004. A work domain analysis framework for modelling intensive care unit patients.
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1998. The Application of the Ecological Interface Design Approach to Neonatal Intensive Care Medicine.
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