Getting the right tools for the job: Preparatory system configuration and active replanning in cardiac surgery

Brian Hazlehurst, Carmit McMullen, Paul Gorman

Research output: Contribution to journalConference article

2 Scopus citations

Abstract

Successful cardiac surgery requires having the right tools for the job in the right place and at the right time, even in the face of unforeseen circumstances. We describe how cognitive and material resources in the activity system of the OR enable well-defined courses of action (through preparatory configuration) while dynamically accommodating unlikely events (through replanning). Using ethnographic data from observations and video recordings in the operating room, we describe the nature of distributed planning in a bounded activity system with defined cognitive and physical resources. We describe the role of preparatory configuration for accomplishing expected courses of action, and the role of active replanning to achieve goals in the face of unexpected circumstances or events. Using a specific case study to illustrate these phenomena, we discuss these findings and their relevance to patient safety.

Original languageEnglish (US)
Pages (from-to)1784-1791
Number of pages8
JournalProceedings of the IEEE International Conference on Systems, Man and Cybernetics
Volume2
StatePublished - Nov 24 2003
EventSystem Security and Assurance - Washington, DC, United States
Duration: Oct 5 2003Oct 8 2003

Keywords

  • Communication
  • Distributed cognition
  • Healthcare
  • Patient safety
  • Surgery
  • Teamwork

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Hardware and Architecture

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