Marian Brandwijk's research while affiliated with The University of Chicago Medical Center and other places

Publications (4)

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
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...

Citations

... Nemeth et al. [23,24] studied 12 between-shift hand-offs at the research site between pediatric fellows who were responsible for PICU management. Accepted wisdom in healthcare information technology (IT) at the time assumed patient hand-offs consisted of a static set of data that could simply be transferred. ...
... This approach emphasizes that communication failures can best be ameliorated through loosely structured, two-way handover interactions, allowing for the 'co-construction' of understanding [7,[10][11][12][13][14][15][16]. It also emphasizes that practitioners need to tell the story of the patient in a manner that fits the singularity of cases and other context factors, such as inexperience [10,13,[17][18][19]. Furthermore, there is a growing case for handovers in complex settings being more than information transfers. ...
... In a small study of intensive care unit handoffs, the authors noted that handoffs are complex, take many forms, and need to focus on what was uncertain. 57 These authors concluded that formulaic approaches to handoffs will not adequately deal with critical care uncertainty and complexity. 57 Others have warned against the use of standardized handoffs for physicians, stating that this will tend to "exacerbate the common problems of handoffs being 'data transfers' rather than meaningful discussions about the patient's status and treatment." ...
... The use of visual management practices (e.g., patient dashboards) and digital technologies (e.g., WhatsApp or similar applications) that allow for the real-time public sharing of accurate and relevant information (Tortorella et al., 2020) might reduce dependence on key players and at the same time support the work of those professionals (Nemeth et al., 2007). ...