The Blog of Harald

Cognitive Properties of a Whiteboard: A Case Study in a Trauma Centre

Abstract.

Distributed cognition as an approach to collaborative work holds that a work unit is cognitive system in which cognitive activities are carried out jointly by workers with the use of tools. This approach has several direct implications to the study of collaborative work. In this paper, we analysed staff interactions with a large display board in a Level I trauma centre operating room unit. Coordination needs are exacerbated by the unpredictability of incoming emergency surgery patients admitted to the trauma centre as well as other contingencies (such as changes in scheduled surgery cases or staffing). The public display board has evolved into a key component for supporting collaborative work. The physical and perceptual properties of the board are exploited by the clinicians to support rapid paced, highly dynamic work. The canvas-like appearances of the display board, combined with magnetic objects attached to the board, afford its users to taylor the board as an effective coordinative tool and to invent new ways of representing information. Based on the concept of display-based cognition, our analysis illustrates the role of public displays in facilitating negotiation of scheduling, joint planning, and augmenting inter-personal communication.

(Update from 2024: In 2009 I started working at the University Health Network on an electronic patient display board for clinicians, fully integrated in real-time with the various clinical systems across the hospital. It was initially rolled to the Emergency Department in about 2007, but quickly expanded across the entire hospital. It was especially popular in two busy locations – the Surgery department at Toronto Western, and the outpatient chemotherapy clinic at Princess Margaret, where coordination requirements were especially dynamic. Now in 2024, it is built-in functionality in every commercial health information system.)