TY - JOUR
T1 - Team Cognition in Handoffs
T2 - Relating System Factors, Team Cognition Functions and Outcomes in Two Handoff Processes
AU - Wooldridge, Abigail R.
AU - Carayon, Pascale
AU - Hoonakker, Peter
AU - Hose, Bat Zion
AU - Shaffer, David W.
AU - Brazelton, Tom
AU - Eithun, Ben
AU - Rusy, Deborah
AU - Ross, Joshua
AU - Kohler, Jonathan
AU - Kelly, Michelle M.
AU - Springman, Scott
AU - Gurses, Ayse P.
N1 - Publisher Copyright:
© 2022, Human Factors and Ergonomics Society.
PY - 2024/1
Y1 - 2024/1
N2 - Objective: This study investigates how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU). We then seek to understand how the sociotechnical system and team cognition are related. Background: Effective handoffs are critical to ensuring patient safety and have been the subject of many improvement efforts. However, the types of team-level cognitive processing during handoffs have not been explored, nor is it clear how the sociotechnical system shapes team cognition. Method: We conducted this study in an academic, Level 1 trauma center in the Midwestern United States. Twenty-eight physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU) participated in semi-structured interviews. We performed qualitative content analysis and epistemic network analysis to understand the relationships between system factors, team cognition in handoffs and outcomes. Results: Participants described three team cognition functions in handoffs—(1) information exchange, (2) assessment, and (3) planning and decision making; information exchange was mentioned most. Work system factors influenced team cognition. Inter-professional handoffs facilitated information exchange but included large teams with diverse backgrounds communicating, which can be inefficient. Intra-professional handoffs decreased team size and role diversity, which may simplify communication but increase information loss. Participants in inter-professional handoffs reflected on outcomes significantly more in relation to system factors and team cognition (p < 0.001), while participants in intra-professional handoffs discussed handoffs as a task. Conclusion: Handoffs include team cognition, which was influenced by work system design. Opportunities for handoff improvement include a flexibly standardized process and supportive tools/technologies. We recommend incorporating perspectives of the patient and family in future work.
AB - Objective: This study investigates how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU). We then seek to understand how the sociotechnical system and team cognition are related. Background: Effective handoffs are critical to ensuring patient safety and have been the subject of many improvement efforts. However, the types of team-level cognitive processing during handoffs have not been explored, nor is it clear how the sociotechnical system shapes team cognition. Method: We conducted this study in an academic, Level 1 trauma center in the Midwestern United States. Twenty-eight physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU) participated in semi-structured interviews. We performed qualitative content analysis and epistemic network analysis to understand the relationships between system factors, team cognition in handoffs and outcomes. Results: Participants described three team cognition functions in handoffs—(1) information exchange, (2) assessment, and (3) planning and decision making; information exchange was mentioned most. Work system factors influenced team cognition. Inter-professional handoffs facilitated information exchange but included large teams with diverse backgrounds communicating, which can be inefficient. Intra-professional handoffs decreased team size and role diversity, which may simplify communication but increase information loss. Participants in inter-professional handoffs reflected on outcomes significantly more in relation to system factors and team cognition (p < 0.001), while participants in intra-professional handoffs discussed handoffs as a task. Conclusion: Handoffs include team cognition, which was influenced by work system design. Opportunities for handoff improvement include a flexibly standardized process and supportive tools/technologies. We recommend incorporating perspectives of the patient and family in future work.
KW - care transitions and handoffs
KW - communication and teamwork in health care
KW - macroergonomics and the environment
KW - system design and analysis
KW - team cognition
UR - http://www.scopus.com/inward/record.url?scp=85131522175&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131522175&partnerID=8YFLogxK
U2 - 10.1177/00187208221086342
DO - 10.1177/00187208221086342
M3 - Article
C2 - 35658721
AN - SCOPUS:85131522175
SN - 0018-7208
VL - 66
SP - 271
EP - 293
JO - Human Factors
JF - Human Factors
IS - 1
ER -