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Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit.

Ashoori M, Burns CM, d'Entremont B, Momtahan K - Ergonomics (2014)

Bottom Line: Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information.As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required.This paper looks at ways of analysing cognitive work in healthcare teams.

View Article: PubMed Central - PubMed

Affiliation: a Department of Systems Design Engineering, University of Waterloo , Waterloo , Canada.

ABSTRACT

Unlabelled: Cognitive work analysis (CWA) as an analytical approach for examining complex sociotechnical systems has shown success in modelling the work of single operators. The CWA approach incorporates social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. In this paper, Team CWA is explored to understand teamwork within a birthing unit at a hospital. Team CWA models are derived from theories and models of teamwork and leverage the existing CWA approaches to analyse team interactions. Team CWA is explained and contrasted with prior approaches to CWA. Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information. As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required.

Practitioner summary: This paper looks at ways of analysing cognitive work in healthcare teams. Team Cognitive Work Analysis, when used to supplement traditional Cognitive Work Analysis, revealed more team information than traditional Cognitive Work Analysis. Team Cognitive Work Analysis should be considered when studying teams.

Show MeSH
Team work domain analysis.
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Figure 1: Team work domain analysis.

Mentions: A WDA reveals constraints at different levels of abstraction in the work domain. The key difference in a Team WDA is that we look at who is influenced by which constraints and what constraints are shared. The Team WDA in Figure 1 shows the domain constraints for the birthing unit, distributed across five key stakeholders. The WDA components and connections remained the same in the Team WDA; however, the Team WDA can explore the WDA further by examining the distribution of components across different stakeholders. In particular, at the physical form level several functional objects are identified. Although these elements are described as objects for the sake of space in the figure, they should be recognised as functional objects with associated capabilities and constraints. For example, various surgical tools have different capabilities and limitations that influence their function. Some of these are constrained by their physical form aspects (e.g. size, material) and some by their nature of the object (e.g. scissors vs. scalpels will have different cutting capabilities). These influence higher levels of the functional hierarchy by playing a role during surgery, as well as the coordination of the surgery (e.g. management of surgical tools). From this analysis we can see that while many values and purposes are shared, there are potential conflicts when functional objects must be shared and processes must be coordinated. Since a Team WDA figure can be difficult to read, the Team WDA was supplemented using tables to identify the relationships created at each level of abstraction. In Table 1, we summarise the key differences noted from the Team WDA that may be helpful above and beyond the traditional WDA.


Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit.

Ashoori M, Burns CM, d'Entremont B, Momtahan K - Ergonomics (2014)

Team work domain analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4066876&req=5

Figure 1: Team work domain analysis.
Mentions: A WDA reveals constraints at different levels of abstraction in the work domain. The key difference in a Team WDA is that we look at who is influenced by which constraints and what constraints are shared. The Team WDA in Figure 1 shows the domain constraints for the birthing unit, distributed across five key stakeholders. The WDA components and connections remained the same in the Team WDA; however, the Team WDA can explore the WDA further by examining the distribution of components across different stakeholders. In particular, at the physical form level several functional objects are identified. Although these elements are described as objects for the sake of space in the figure, they should be recognised as functional objects with associated capabilities and constraints. For example, various surgical tools have different capabilities and limitations that influence their function. Some of these are constrained by their physical form aspects (e.g. size, material) and some by their nature of the object (e.g. scissors vs. scalpels will have different cutting capabilities). These influence higher levels of the functional hierarchy by playing a role during surgery, as well as the coordination of the surgery (e.g. management of surgical tools). From this analysis we can see that while many values and purposes are shared, there are potential conflicts when functional objects must be shared and processes must be coordinated. Since a Team WDA figure can be difficult to read, the Team WDA was supplemented using tables to identify the relationships created at each level of abstraction. In Table 1, we summarise the key differences noted from the Team WDA that may be helpful above and beyond the traditional WDA.

Bottom Line: Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information.As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required.This paper looks at ways of analysing cognitive work in healthcare teams.

View Article: PubMed Central - PubMed

Affiliation: a Department of Systems Design Engineering, University of Waterloo , Waterloo , Canada.

ABSTRACT

Unlabelled: Cognitive work analysis (CWA) as an analytical approach for examining complex sociotechnical systems has shown success in modelling the work of single operators. The CWA approach incorporates social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. In this paper, Team CWA is explored to understand teamwork within a birthing unit at a hospital. Team CWA models are derived from theories and models of teamwork and leverage the existing CWA approaches to analyse team interactions. Team CWA is explained and contrasted with prior approaches to CWA. Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information. As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required.

Practitioner summary: This paper looks at ways of analysing cognitive work in healthcare teams. Team Cognitive Work Analysis, when used to supplement traditional Cognitive Work Analysis, revealed more team information than traditional Cognitive Work Analysis. Team Cognitive Work Analysis should be considered when studying teams.

Show MeSH