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Work coordination, workflow, and workarounds in a medical context

Published: 02 April 2005 Publication History

Abstract

In this paper we report an ethnographic study of workarounds-informal temporary practices for handling exceptions to normal workflow-in a hospital environment. Workarounds are a common technique for dealing with the inherent uncertainty of dynamic work environments. Workarounds can help coordinate work, especially under conditions of high time pressure, but they may result in information or work protocols that are unstable, unavailable, or unreliable. We investigated workarounds and their effects through observation and interviews in a major teaching medical center. Our results suggest 4 key features of workarounds that technologies might help address: (a) workarounds differ as a function of people's role; (b) workarounds draw on tacit knowledge of others' abilities and willingness to help; (c) workarounds can have a cascading effect, causing other workarounds down the line; (d) workarounds often rely on principles of fairness and who owes whom a favor. We provide recommendations for designing systems to better support workarounds in dynamic environments.

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cover image ACM Conferences
CHI EA '05: CHI '05 Extended Abstracts on Human Factors in Computing Systems
April 2005
1358 pages
ISBN:1595930027
DOI:10.1145/1056808
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

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Publication History

Published: 02 April 2005

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Author Tags

  1. CSCW
  2. awareness
  3. breakdowns
  4. computer-supported collaborative work
  5. coordination
  6. modeling
  7. problem-solving
  8. social cognition
  9. transactive memory
  10. workarounds
  11. workflow

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Cited By

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  • (2025)The Ripple Effect of Information InfrastructuresComputer Supported Cooperative Work (CSCW)10.1007/s10606-024-09509-7Online publication date: 4-Jan-2025
  • (2024)Revisiting Grudin’s eight challenges for developers of groupware technologies 30 years lateri-com10.1515/icom-2023-003923:1(7-31)Online publication date: 21-Mar-2024
  • (2024)Implications of refugee crisis on public sector healthcare organizations: Empirical observation from Myanmar’s Rohingya refugees in BangladeshJournal of Refugee Studies10.1093/jrs/feae06237:3(697-715)Online publication date: 11-Jul-2024
  • (2024)Digital Desire Paths: Exploring the Role of Computer Workarounds in Emergent Information Systems DesignEuropean Journal of Information Systems10.1080/0960085X.2024.231353733:2(145-160)Online publication date: 15-Feb-2024
  • (2024)The Pivotal Role of Workarounds for Navigating Challenges in Digital WorkNavigating Digital Transformation10.1007/978-3-031-76970-2_7(95-112)Online publication date: 29-Dec-2024
  • (2023)Safety risks and workflow implications associated with nursing-related free-text communication ordersJournal of the American Medical Informatics Association10.1093/jamia/ocad01830:5(828-837)Online publication date: 20-Feb-2023
  • (2023)Why Work Around the Process? Analyzing Workarounds Through the Lens of the Theory of Planned BehaviorBusiness & Information Systems Engineering10.1007/s12599-023-00802-165:4(369-389)Online publication date: 7-Mar-2023
  • (2022)Workarounds in Electronic Health Record Systems and the Revised Sociotechnical Electronic Health Record Workaround Analysis Framework: Scoping ReviewJournal of Medical Internet Research10.2196/3304624:3(e33046)Online publication date: 15-Mar-2022
  • (2022)Working around inadequate information systems in the workplace: An empirical study in RomaniaInternational Journal of Information Management10.1016/j.ijinfomgt.2022.10247164(102471)Online publication date: Jun-2022
  • (2022)Inverted Hierarchies on the Shop Floor: The Organisational Layer of Workarounds for Collaboration in the Metal IndustryComputer Supported Cooperative Work10.1007/s10606-021-09415-231:1(111-147)Online publication date: 1-Mar-2022
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