AMIA2014 Workflow Paper (Monday) Cognitive design of a digital desk for the emergency room setting

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10:30PM Monday

“The aim of this study was to examine how workflow processes uncovered in ethnographic workplace studies can be transformed into representations and systems functionality in a digital healthcare context. We present the ER Desk – a digital desk that was designed specifically to support a small team of clinicians working tightly in an emergency room setting.

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The main team coordination artefact was an ordinary desk, centrally placed in the ER, with stacked patient folders (see Figure 1). It was used to visualize the current state of the clinic and the workflow. The arrangement of patient folders on this desk portrayed an overview of all cases being treated by members of the surgical team. The large display of folders (about 100 by 100 cm) facilitated an on-the-fly visual evaluation of the amount of work to be done. From a cognitive perspective, representations such as this arrangement function as an external memory and allow clinicians the use of less demanding, low-level perceptual routines (i.e., seeing the folders on the table) rather than high-level cognitive processes (i.e., keeping a list of cases in working memory) to assess a situation.

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The overall design was implemented on a large, multitouch digital desk and was focused on supporting collaborating teams working in an emergency room setting. The design can be conceptualized as a shared workspace for physicians, nurses and nurse’s aids. The overall goal was to allow the patient records – particularly the temporary clinical information and documents about the patients under treatment in the ward – to be visualised and accessed directly as virtual folders on a digital work surface to provide functional mapping from the paper-based system to the digital.”

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