Health care, as well as many industries in today’s society, consists of complex sociotechnical systems, i.e. people working with technology(ies) in an organization and a physical environment, and interacting with various processes. Team organization is one approach to handle increasing system and process complexity, especially the potential for safety outcomes, high task difficulty and uncertainty. Team cognition, including cognitive tasks such as planning, decision making, problem assessment and solving, is important for team performance; but, team cognition can be challenging in fluid teams (where membership changes) and distributed teams (where members work across boundaries such as time, space and organization). Using interactive team cognition (ICT) and macroergonomics theories, I conduct mixed methods research to study team cognition in the wild, i.e. in situated contexts. This presentation focuses on team cognition in the complex sociotechnical system of pediatric trauma care. Trauma is the leading cause of death in children and young adults in the US, and thus any improvements in care team performance could have an important impact on reducing morbidity and mortality of those pediatric patients. Pediatric trauma care teams are large, fluid and distributed, and the pediatric trauma care process is complex and distributed across time and space. Therefore, care involves transitions between hospital units. Care transitions are an example of teamwork in health care that contributes to high-quality patient care. Using a sociotechnical process mapping method, I describe the pediatric trauma care transition process, including activities associated with preparation, transition and follow up phases. A preliminary analysis of work system barriers and facilitators experienced by healthcare professionals includes issues related to team cognition, such as team members being in the same place to see and hear the same information and healthcare professionals handing patients off together between units rather than separately (i.e., inter-professional handoffs instead of intra-professional handoffs). Future work will assess differences in team cognition in inter- versus intra- professional handoffs and describe how team cognition occurs in inter-professional handoffs.
Abigail Wooldridge is a doctoral candidate in the Department of Industrial and Systems Engineering and a research assistant at the Center for Quality and Productivity Improvement at the University of Wisconsin-Madison. Her research addresses the design of complex healthcare sociotechnical systems using mixed methods research designs. Abigail received her Bachelor of Science and Master of Engineering in Industrial Engineering focusing on applied statistics and operations research from the University of Louisville in 2012, and her Master of Science in Industrial and Systems Engineering focusing on human factors and ergonomics from University of Wisconsin-Madison in 2013. Between 2013 and 2015, she managed Decision Support and Surgical Scheduling at the University of Miami Ann Bates Leach Eye Hospital.