Christopher P. Nemeth

Christopher P. Nemeth
Applied Research Associates, Inc. | ARA · Cognitive Solutions Division

PhD Human Factors and Ergonomics; MS Product Design

About

100
Publications
21,317
Reads
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1,793
Citations
Additional affiliations
March 2009 - present
Applied Research Associates, Inc.
Position
  • Principal Investigator
Description
  • I study human performance in high risk sectors to learn about the effects of technology, and how it can be improved to benefit human performance. My work encompasses management, human factors, design, and expert witness and product development services.
May 2003 - March 2009
University of Chicago
Position
  • Professor (Assistant)
Description
  • Research into cognition and systems to improve safety and reliability as full-time member of faculty. Period also includes work as Post-Doctoral Scholar.
September 1997 - May 1999
Northwestern University
Position
  • Lecturer
Description
  • Member of faculty team that created curriculum in design and communication for College of Engineering. Now required for all NU freshman engineers.
Education
August 2001 - October 2003
Union Institute and University
Field of study
  • Human Factors-Ergonomics
September 1979 - August 1984
Illinois Institute of Technology-Institute of Design
Field of study
  • Product Design
September 1967 - May 1971
Marquette University
Field of study
  • Political Science

Publications

Publications (100)
Book
Resilience Engineering (RE) studies have successfully identified and described many instances of resilient performance in high hazard sectors as well as in the far more frequent cases where people and organisations cope with the uncertainties of daily operations. Since RE was first described in 2006, a steady accumulation of insights and efforts ha...
Conference Paper
Tactical combat casualty care (TCCC) involves care for casualties in armed conflict from one’s own service (e.g., U.S. Marine Corps), other services (i.e., U.S. Army, Air Force,), allied forces, adversaries, and civilians. To minimize injury and preserve life, medics perform TCCC which includes casualty retrieval, stabilization and documentation, t...
Chapter
Looking back at how resilience engineering made its entry onto the safety arena in 2004, resilience was initially seen as a substitute, and part extension, of safety, hence as something that could be engineered or managed. In the years since then it has become clear that how systems perform, and especially whether the performance is resilient, is m...
Chapter
In the end, we must keep in mind that it is more important to ask the right questions than simply to hunt for answers to the questions that we – and others – habitually ask.
Chapter
In Tactical Combat Casualty Care (TCCC), evacuation from a battlefield may not be immediately available, resulting in a medic providing Prolonged Field Care (PFC) for one or more casualties over hours or days. We report on the development and evaluation of the Trauma Triage Treatment and Training Decision Support (4TDS) system, an Android phone and...
Chapter
Patient care, particularly care for acute patients, relies on improving healthcare’s ability to anticipate surprising challenges and develop greater flexibility, making it easier to adapt when challenges occur. Use of simulation can expand the understanding of performance limits, safety margins, what happens when margins are violated, and how to ch...
Article
Objectives The objectives of this study were to test in real time a Trauma Triage, Treatment, and Training Decision Support (4TDS) machine learning (ML) model of shock detection in a prospective silent trial, and to evaluate specificity, sensitivity, and other estimates of diagnostic performance compared to the gold standard of electronic medical r...
Article
Full-text available
Introduction The emergence of more complex Prolonged Field Care in austere settings and the need to assist inexperienced providers’ ability to treat patients create an urgent need for effective tools to support care. We report on a project to develop a phone-/tablet-based decision support system for prehospital tactical combat casualty care that co...
Article
Objectives: Predictions estimate supplies of filtering facepiece respirators (FFRs) would be limited in the event of a severe influenza pandemic. Ultraviolet decontamination and reuse (UVDR) is a potential approach to mitigate an FFR shortage. A field study sought to understand healthcare workers' perspectives and potential logistics issues relate...
Article
Integrating training into the design and development of new systems is a challenging goal for many organizations. Embedded training (ET) has been a research topic for many years, but as systems become more complex, teams more distributed, and development and training timelines shortened, ET is more critical. This panel with research and operational...
Article
Full-text available
Introduction The electronic medical record (EMR) is presumed to support clinician decisions by documenting and retrieving patient information. Research shows that the EMR variably affects patient care and clinical decision making. The way information is presented likely has a significant impact on this variability. Well-designed representations of...
Article
Full-text available
Purpose of review Resilience is a concept that has become popular recently that evolved from studies of the natural environment and is used to refer to many different applications, from individuals, to communities, to systems. Resilience engineering (RE) has been developed to better understand system performance in high-risk sectors including healt...
Conference Paper
Understanding high risk work settings from the viewpoint of resilience engineering (RE) requires methods that enable the researcher to successfully collect and analyze data, then provide well-founded findings and recommendations. We report on our experience using one RE method, the Resilience Analysis Grid (RAG) to assess the organizational resilie...
Article
The fragile health of patients who are admitted to a burn intensive care unit (ICU) requires clinicians and clinical teams to perform complex cognitive work that includes time-pressured diagnostic and therapeutic decisions that are based on emergent and interrelated patient information. Barriers to clinician efforts delay patient care and increase...
Article
Multidisciplinary rounds (MDRs) in the burn intensive care unit serve as an efficient means for clinicians to assess patient status and establish patient care priorities. Both tasks require significant cognitive work, the magnitude of which is relevant because increased cognitive work of task completion has been associated with increased error rate...
Article
Background: Burn Intensive Care Unit (BICU) work is necessarily complex and depends on clinician actions, resources, and variable patient responses to interventions. Clinicians use large volumes of data that are condensed in time, but separated across resources, to care for patients. Correctly designed health information technology (IT) systems ma...
Chapter
This chapter describes an 18-month project to demonstrate how to incorporate human centered design into the Navy's systems acquisition process. The project provides a common language for the chief of Naval operations and the Naval sea systems command staff to use in the acquisition of systems that are intended to support decision-making. Navy exped...
Article
Sensitivity to patient needs makes clinicians the primary source of adaptive capacity, or resilience, in the intensive care unit (ICU). Work setting complexities and contingencies make cognitive work in this setting particularly challenging. A IT-based system to support individual and team decisions and communication would increase clinicians' capa...
Article
Full-text available
From July to October 2009, a team of human factors researchers evaluated the use of a commercially available infusion device among nurses at a tertiary care hospital in the Midwest. The study's purpose was to determine the factors that may influence the adoption and "best practice" use of smart infusion devices by identifying the human, technologic...
Book
Full-text available
Cognitive engineering is an interdisciplinary approach to the analysis, modeling, and design of engineered systems or workplaces in which humans and technologies jointly operate to achieve system goals. As individuals, teams, and organizations become increasingly reliant on information technology and automation, it is more important than ever for s...
Conference Paper
Introduction: The purpose of this study is to improve care by supporting clinical decision-making by identifying design requirements for computerized cognitive aides and communication tools. Methods: This project is divided into three phases: foundation research, prototype development, and prototype assessment. In phase I, we conduct one-week data...
Conference Paper
Introduction: The purpose of this study is improve care by supporting clinical decision-making by identifying design requirements for computer-based decision support and communication tools. Methods: This project is divided into three phases: foundation research, prototype development, and prototype assessment. In phase I, we conduct one-week data...
Article
This panel will discuss emerging areas in cognitive engineering from several researchers and practitioners who are defining their own research directions. The panelists will be challenged to discuss what they see as the design challenges that cognitive engineering is uniquely suited to answer. Further, they will be asked what grand challenges cogni...
Article
Cognitive Engineering methods were developed to enable human factors practitioners to understand and systematically support the cognitive work of people working “at the sharp end of the spear.” Military members for whom DoD acquisition organizations develop systems are the quintessential “sharp end of the spear.” This panel is proposed to share pre...
Article
Full-text available
Understanding how people adapt to change and uncertainty is critical to system design, and good system design expands the ability of people to adapt. Cognitive systems engineering (CSE) enables us to understand work domains, reveal expertise, and derive essential features for systems. This is valuable because the demand for rapidly evolving systems...
Article
Full-text available
Cognitive task analysis is the study of macrocognitive work and the modeling of the knowledge and reasoning of domain experts, which inform the creation of intelligent systems. Over the past quarter-century, most research on decision-making and other aspects of macrocognition has been conducted using some form of cognitive task analysis. In this es...
Book
Communications research in aviation is widely regarded by many in the healthcare community as the ‘gold standard’ to emulate. Yet healthcare and aviation differ in many ways, as do the vital communications shared among members of clinical teams. Aviation team communication should, then, be understood in terms of what lessons will benefit those who...
Conference Paper
Operational U.S. Navy missions require routine performance of multiple complex cognitive and macrocognitive tasks such as planning and sensemaking under demanding conditions. However, the Department of Defense systems acquisition process accounts for only simpler behavioral tasks. This disparity is most evident in command and control systems that a...
Article
Full-text available
Like other high hazard sectors, successful crisis response relies on a well-founded understanding of the work domain and the manner in which operators perceive and deal with obstacles to achieving goals. That understanding is essential to the development of information and communications technology (ICT) that are intended to support operator perfor...
Article
While military command and control (C2) systems are intended to support operator cognitive work, current US Navy system engineering processes only capture behavioral-level tasks. Deployed forces in high threat settings need support for cognitive and macrocognitive work including planning, replanning, sensemaking and situation awareness. We describe...
Chapter
The naturalistic decision making (NDM) approach seeks to understand human cognitive performance by studying how individuals and teams choose among alternatives in real-world settings. Unlike laboratory studies, NDM research captures human interactions with actual work settings that are typically uncertain, complex, fluid, and time-pressured. The ND...
Article
Full-text available
Resilience engineering strives to build the adaptive capacity of systems that is essential to continue operations in the face of substantial challenges. The healthcare enterprise provides a compelling opportunity to consider resilience as a desirable trait of systems. Clinicians, from physicians to nurses and technicians, are a source of resilience...
Article
Erik Hollnagel's body of work in the past three decades has molded much of the current research approach to system safety, particularly notions of ''error''. Hollnagel regards ''error'' as a dead-end and avoids using the term. This position is consistent with Rasmussen's claim that there is no scientifically stable category of human perfor- mance t...
Article
Cognitive artifacts are created and used to support task performance in many domains. These artifacts may be essential components designed into a process, they may have been created by users as work-arounds to system shortcomings, or they may be extensions to systems that add functionalities to meet evolving needs. Examination of cognitive artifact...
Book
Full-text available
Preparation and Restoration is the second volume of Resilience Engineering Perspectives within the Ashgate Studies in Resilience Engineering series. In four sections, it broadens participation of the field to include policy and organization studies, and articulates aspects of resilience beyond initial definitions: - Policy and Organization explores...
Article
We report on a human factors evaluation project at a major urban teaching hospital that was intended to use human factors methods to assist the selection of a new infusion device among 4 commercially available models. The project provided an expert evaluation of the pumps, collected data on programming each pump by a sample of practitioners, tabula...
Article
Design cycles for rapidly-evolving systems such as information and communication technology (ICT) are too short to allow for long-term deliberation. We need means to learn about how people adapt to change and uncertainty and how complex systems behave. We also need to learn how to elicit and understand true expertise in work settings and make it us...
Article
Each professional discipline has a set of essential concepts that form the core of its intellectual capital. This is also true for human factors and ergonomics (HF/E), but what is that set? HFES national meeting sessions address particular research interests. However, no session embraces essential aspects that affect the entire HF/E community. Four...
Chapter
Full-text available
Resilience is the intrinsic ability of a system to adjust its functioning prior to, during, or following changes and disturbances so that it can sustain required operations, even after a major mishap or in the presence of continuous stress. As an emergent property of systems that is not tied to tallies of adverse events or estimates of their probab...
Article
In the resilience engineering approach to safety, failures and successes are seen as two different outcomes of the same underlying process, namely how people and organizations cope with complex, underspecified and therefore partly unpredictable work environments. Therefore safety can no longer be ensured by constraining performance and eliminating...
Conference Paper
Healthcare information technology (IT) systems can be used to inform workers and managers about changes to workplace vulnerabilities and new means that may be available to meet challenges such as widely varying demand. IT system success, though, depends on adaptability in the face of change, which is a property that IT systems do not currently demo...
Article
Full-text available
System performance in healthcare pivots on the ability to match demand for care with the resources that are needed to provide it. High reliability is desirable in organizations that perform inherently hazardous, highly technical tasks. However, healthcare's high variability, diversity, partition between workers and managers, and production pressure...
Article
This special joint session (sponsored by Health Care TG and Forensics TG) at the 2007 annual meeting of HFES presents an enactment of a court trial involving an automated external defibrillator (AED). The mock trial session presents human factors issues related to the design and use of the AED which lead to the death of an individual who collapsed...
Article
The flow of technical work in acute healthcare varies unpredictably, in patterns that occur regularly enough that they can be managed. Acute care organizations develop ways to hedge resources so that they are available if they are needed. This pragmatic approach to the distribution of work among and across groups shows how rules can be used to mana...
Article
The first special issue in Large-Scale Coordination earlier this year showed the breadth of application research from air traffic control to the military and multi-agency emergency response. This special issue shows depth of research at large scale in healthcare. These studies of large-scale coordination examine work between and across groups, bey...
Article
From the Department of Emergency Medicine, University of Florida, Jacksonville, FL, and ClinicalSafety Research Unit, Imperial College, London, England (Wears); and the Cognitive TechnologiesLaboratory, University of Chicago, Chicago, IL (Nemeth).0196-0644/$-see front matterCopyright © 2007 by the American College of Emergency Physicians.doi:10.101...
Article
Full-text available
Study of large-scale coordination seeks us to understand work between and across groups beyond earlier conceptions of social human factors. Revealing the complexity of work domains and the subtle yet effective ways that workers negotiate its challenges opens the way to develop support tools that are grounded in a scientific understanding. This firs...
Article
Transitions between shifts in the intensive care unit (ICU) create potential gaps in the continuity of care, and practitioners necessarily rely on distributed cognition to prevent the formation of gaps during work-cycle shift changes. The complexity and uncertainty of each ICU patient's condition require efficient communication between practitioner...
Article
Full-text available
Thorough, objective investigation of medical adverse events rarely happens due to the com- plexity of the environment, litigation, risk, and socio-political implications. Special concerns can, and do, undermine investigation depth, breadth, and quality. Healthcare's distinct differ- ence from other high hazard sectors requires a unique approach to...
Article
Healthcare systems, especially hospital operating room suites, have properties that make them ideal for the study of the cognitive work using the naturalistic decision-making (NDM) approach. This variable, complex, high-tempo setting provides a unique opportunity to examine the ways that clinicians plan, monitor, and cope with the irreducible uncer...
Article
Full-text available
Information technology (IT) systems have been described as brittle and prone to automation surprises. Recent reports of information system failure, particularly computerized physician order entry (CPOE) systems, shows the result of such IT failure in actual practice. Such mismatches with healthcare work requirements require improvement to IT resear...
Article
Full-text available
Naturalistic decision making (NDM) methods have previously been applied to understand individual and group cognition. The systemic aspects of work that are unavailable through the study of individuals or a single group can be revealed by cognitive research at large scale, among and across groups. The papers in this symposium explore the use of NDM...
Article
With the rise in chronic, behavior-related disease, computerized behavioral protocols (CBPs) that help individuals improve behaviors have the potential to play an increasing role in the future health of society. To be effective and widely used CBPs should ...
Article
Healthcare demonstrates the same properties of risk, complexity, uncertainty, dynamic change, and time-pressure as other high hazard sectors including aviation, nuclear power generation, the military, and transportation. Unlike those sectors, healthcare has particular traits that make it unique such as wide variability, ad hoc configuration, evanes...
Article
Full-text available
The failure of automation to improve clinical performance is likely rooted in the design concepts on which IT systems are based. Current systems provide clinicians with specific direction about how to care for individual patients. This is much like the specific, detailed, complicated, and narrow trip route driving directions that can be obtained fr...
Chapter
Objective: To fulfill the promise of information technology in health care, automation must be made into a “team player.” Methods: Observational research in both the laboratory and field focused on how subjects program infusion devices. These programming activities were examined in detail for a set of tasks, using experienced clinicians as subjects...
Chapter
Objectives: Our research seeks to discover the deep structure of practitioner cognitive work. The purpose is to improve the capture, use, and sharing of information related to clinical planning and management at the clinical unit level, which shapes the unit's work and leads to success or failure of patient care.Methods: Field observation, informal...
Article
Full-text available
With increasing attention to patient safety, hospitals and other clinical facilities are developing practice guidelines and protocols with the specific intent of reducing harm to patients. However, the introduction of these protocols can have unanticipated ...
Article
Full-text available
Studies of patient safety have identified gaps in current work including the need for research about communication and information sharing among healthcare providers. They have also encouraged the use of decision support tools to improve human performance. Distributed cognition is the shared awareness of goals, plans, and details that no single ind...
Article
The advent of fast-acting drugs has made the infusion pump the most pervasive electronic medical device in the acute care (hospital) environment. Despite the importance of its correct operation, incident reports in the US Food and Drug Administration (FDA) database implicate interface programming as a significant aspect of adverse outcomes. This ar...