What Whiteboards in a Trauma Center Operating Suite Can Teach Us About Emergency Department Communication
Received 1 July 2006; received in revised form 29 December 2006; accepted 26 March 2007. published online 11 May 2007.
Refers to article:
Studying the Technical Work of Emergency Care
Christopher P. Nemeth, Richard I. Cook, Robert L. Wears
Annals of Emergency Medicine
October 2007 (Vol. 50, Issue 4, Pages 384-386) Full Text |
Full-Text PDF (68 KB)
Study objective
Highly reliable, efficient collaborative work relies on excellent communication. We seek to understand how a traditional whiteboard is used as a versatile information artifact to support communication in rapid-paced, highly dynamic collaborative work. The similar communicative demands of the trauma operating suite and an emergency department (ED) make the findings applicable to both settings.
Methods
We took photographs and observed staff’s interaction with a whiteboard in a 6-bed surgical suite dedicated to trauma service. We analyzed the integral role of artifacts in cognitive activities as when workers configure and manage visual spaces to simplify their cognitive tasks. We further identified characteristics of the whiteboard as a communicative information artifact in supporting coordination in fast-paced environments.
Results
We identified 8 ways in which the whiteboard was used by physicians, nurses, and with other personnel to support collaborative work: task management, team attention management, task status tracking, task articulation, resource planning and tracking, synchronous and asynchronous communication, multidisciplinary problem solving and negotiation, and socialization and team building. The whiteboard was highly communicative because of its location and installation method, high interactivity and usability, high expressiveness, and ability to visualize transition points to support work handoffs.
Conclusion
Traditional information artifacts such as whiteboards play significant roles in supporting collaborative work. How these artifacts are used provides insights into complicated information needs of teamwork in highly dynamic, high-risk settings such as an ED.
aUniversity of Maryland School of Medicine, Baltimore, MD
bUniversity of Maryland R.H. Smith School of Business, College Park, MD
Address for correspondence: Yan Xiao, PhD, Division of Research in Patient Safety, Program in Trauma, University of Maryland, 22 S Greene St, Baltimore, MD 21201, 410-328-7179, fax 410-328-7230
Supervising editor: Robert L. Wears, MD, MS
Author contributions: YX conceived the study, design the study, and supervised data collection. YX, SF, and CFM obtained the funding. YX, SS, and CFM drafted the article. YX, SF, and JM developed concept framework. YX takes responsibility for the paper as a whole.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This research was supported by National Science Foundation (ITR-0081868 and ITR-0325087). The views expressed here are those of the authors and do not reflect the official policy or position of the authors’ employers nor the funding agency.
ABSTRACT