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Coordination

Additional projects

The research is driven by the goal of understanding potential roles of information technology in facilitating coordination of care activities. Research projects include national survey of levels I and II trauma centers on the use of communication technology, acquisition of video and patient flow data automatically to support operating room management, development of advanced interfaces to facilitate coordination, and development of algorithms to visualize data for OR management.

Dialogic coordination of trauma teams

Yan Xiao with lead author Samer Faraj (professor at Smith School of Business) reported their major in-depth study of trauma teams in an 2006 issue of Management Science. Facing coordination challenges that were previously poorly studied, trauma teams employ expertise coordination practices of relying on protocols and flexible teaming to counter extreme demands of expertise and resources at times in a busy trauma center. The abilities of trauma teams to cross monitor and adapt protocols were modeled as dialogic coordination: interactive processes among care providers of different disciplines in time-critical responses to novel events and to ensure error-free operation. [Sponsored by NSF]

Who takes care of a trauma patient in the first 15 minutes of admission?

Young-Ju Kim (then a doctoral student from School of Nursing) and collaborators analyzed the availability of trauma specialists in Level I and II trauma centers through a national survey, which will be published in Journal of Trauma. Upon admission only 37% of the trauma centers responded to have trauma surgeons present. For low patient volume centers, early triage, and better notification systems should be considered to better utilize trauma surgeons. [Sponsored by NSF]

Coordination when operating at capacity, resiliently

Anne Miller (while visiting from Down Under) and Yan Xiao studied how a trauma center responded to fluctuating care demands that will be published in Cognition, Technology, & Work, a journal dedicated to cognitive engineering. Interviews with clinicians with administrative roles were conducted that uncovered multi-level strategies to compensate seasonal variations of care demands. Overlapping shifts were used to tackle daily variations. [Sponsored by NSF]

Negotiation in care coordination

Yan Xiao and colleagues (including collaborators from Carnegie Mellon University) reported their field studies on conflict management in often contentious process of managing operating rooms in an upcoming issue in Cognition, Technology, & Work on large scale collaboration . Coordinators at the “sharp end” are frequently confronted with conflicts. To manage conflicts, they developed ways to induce perceived fairness, often through opportunistic means. Information technology may be difficult for coordinators to manage conflicts because, for example, it can be difficult for them to be tactful in communication. [Sponsored by NSF]