Breaks in Continuity of Surgical Care: Considerations for eHealth Systems Design

摘要

Coordination in healthcare settings is a complex distributed process, mediated by a number of artifacts. We describe the coordination mechanisms in a surgical unit and identify the critical themes and structures of coordination that reveal the coordination needs of clinicians. Interestingly, we find that intra-team coordination works well despite the fact that it is mostly implicit. It is inter-team explicit coordination that presents significant overhead, the main effort being in maintaining awareness system-wide. We discuss the implications for eHealth systems design.