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Cognitive Work Analysis in Health Care
Book chapter

Cognitive Work Analysis in Health Care

Michelle L Rogers
Handbook of Human Factors and Ergonomics in Health Care and Patient Safety, pp 494-503
2012

Abstract

Adoption of technology has been proposed as a means to reduce medical error (Kohn et al., 1999). This reduction might be derived through automation of tasks, monitoring, and improved oeexibility of data handling directed toward better situation assessment (Puckett, 1995, Sarter et  al., 1997; Potter et al., 2000). Studies of accidents, however, consistently demonstrate that new computerized systems predictably affect human problem-solving ability in ways that often contribute to accidents. Experience with technology’s contribution to new failures is widespread, ranging from personal catastrophes by unintentional, but unrecoverable, keystrokes that wipe out entire fles (Norman, 1983) to software problems that crashed NASA’s Mars exploration mission (Young et al., 2000). As health care moves toward increasing dependence on computerized tools; order entry, electronic medical records, and medication administration to name just a few, their design of these computerized tools to support human work (e.g., make it easier, faster, safer, and more accurate) also increases in importance. Recent reports, including the failure of computerized order entry at Cedars Sinai (Chin, 2003), as well as unexpected consequences with implementation of patient care information systems reported by Ash et al. (2004) and bar coded medication administration by Patterson et al. (2002), lend credence to this view. Cognitive work analysis (CWA) is a method that models how environmental, organizational, individual, and technical constraints contribute to work in order to design tools that support work. This methodology, applied to health care systems, could improve safety, effcacy, effciency, and the acceptance of computerized tools by health care providers.

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