Work coordination, workflow, and workarounds in a medical context
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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Workarounds perceived as necessary by the user for patient care, efficiency, or safety may be beneficial, neutral, or dangerous for patients' safety.
“Thus, workarounds perceived as necessary by the user for patient care, efficiency, 33 or safety, 34 may be beneficial, neutral, or dangerous for patients' safety 33,35-37”
From Workarounds to Barcode Medication Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety (2008) · cites this paper as [33]
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- Authors
- Kobayashi, M., Fussell, S. R., Xiao, Y., & Seagull, F. J.
- Affiliations
- Carnegie Mellon University (US)
- University of Maryland, Baltimore (US)
- Venue
- CHI '05 Extended Abstracts on Human Factors in Computing Systems
- Publisher
- ACM
- Published
- 2005-04-02
- Pages
- 1561-1564
- OpenAlex
- W2119704473
- Cited by
- 141
- References
- 7
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 8 · 2020: 7 · 2019: 8 · 2018: 9 · 2017: 12 · 2016: 4 · 2015: 14 · 2014: 12 · 2013: 11 · 2012: 7
- FWCI
- 7.08
- Type
- conference paper
- Language
- en
- Open access
- closed
- Locations
- CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) (publishedVersion)
- Funders
- National Science Foundation
- Topics
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
- Keywords
- workarounds, informal work practices, hospital workflow, work coordination, tacit knowledge, time pressure, role differences, medical work
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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