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Cognitive Artifacts' Implications for Health Care Information Technology: Revealing How Practitioners Create and Share Their Understanding of Daily Work.


In: Henriksen K, Battles JB, Marks ES, Lewin DI, editors.


Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb.
Advances in Patient Safety.


Objectives: Our research seeks to discover the deep structure of practitioner cognitive work. The purpose is to improve the capture, use, and sharing of information related to clinical planning and management at the clinical unit level, which shapes the unit's work and leads to success or failure of patient care.Methods: Field observation, informal interviews, artifact analysis, and controlled study were used to examine the creation and use of shared cognitive artifacts, particularly the operating room schedule, as a way to reveal individual and group cognition.Results: This work shows how practitioners anticipate, plan, and accommodate demands for care in a setting (such as a surgical suite) with constrained resources and variable uncertainty. It also demonstrates how practitioners create and maintain cognitive artifacts that represent the day's work.Conclusions: The study of cognitive artifacts can identify critical features of the acute care work domain and the deep structure of individual and team cognition, reveal the nature of artifacts, show these artifacts' role as a part of the team's distributed cognition, and suggest opportunities for the development of computer-supported artifacts.

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