Sensemaking, safety, and cooperative work in the intensive care unit

摘要

Making sense of circumstances and situations is critical to coordinate cooperative work. Especially in process control domains, we may expect that effective and reliable organizations will possess processes that develop, maintain, distribute, and, when necessary, repair this social understanding (sensemak-ing). Our research has focused on collective sense-making process in an intensive care unit (ICU). Thus, sensemaking is most likely to be visible to researchers in high tempo, high uncertainty work settings such as hospital ICU, where complexity, criticality, and uncertainty are the main characteristics of the working activities and making sense of what is happening is one of the most important challenge of the team of physicians working in this context. The research demonstrates how workers create and distribute sense within small work groups and also how they use the results of these efforts to coordinate ongoing work activities. Practitioners tradeoff the opportunity costs of formal, collective sensemaking {sensemaking at intervals) against the value that this preparation provides to sensemaking during high tempo work (sensemaking on-the-fly). Further study of this dynamic balance will provide insight about how practitioners construct platforms for action during future, uncertain, high stakes work.