Collaborative information seeking: A field study of a multidisciplinary patient care team

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Abstract

Multidisciplinary teams are an essential aspect of modern organizational work. These teams often work in information-rich environments but little is known about their collaborative information seeking (CIS) behavior. We have been studying the CIS behavior of teams in the context of medical care. We conducted an ethnographic field study of a multidisciplinary patient care team in an emergency department to identify (a) team information needs and (b) situations that trigger collaborative information seeking activities. We identified seven categories of information needs as expressed by questions asked by team members. The majority of questions focused on medical information, but there were a larger than expected percentage of questions focusing on organizational information. We also identified three triggers for CIS activities. These triggers are: (1) lack of expertise, (2) lack of immediately accessible information, and (3) complex information needs. The questions and triggers highlight the importance of face-to-face communication during CIS activities and how CIS activities could lead to interruptive workplaces. We also discuss organizational and technical implications for supporting CIS behavior of teams.

Introduction

Information seeking and management activities are a prominent aspect of everyday work. In organizations, information plays a vital role not only in decision-making but also in coordinating, contextualizing, and providing awareness of others’ activities (Berg, 1999). Consequently, organizations are paying more attention to their information seeking and management practices. Within these settings, information seeking is conceptualized as essentially an individual, rather than a collaborative activity (Ellis, 1989, Hansen and Jarvelin, 2005, Sonnenwald and Pierce, 2000). However, individuals rarely work independently in modern organizational settings. Instead, the dominant setting for information work in these environments is interdisciplinary or multifunctional teams (Baggs et al., 1992, Gorman et al., 2000, Hansen and Jarvelin, 2005). These teams are critical to an organization’s ability to implement its goals. One key element to team success is their ability to work together to seek information efficiently and effectively. Increasingly, researchers are starting to examine information seeking as a collaborative activity in a wide variety of team settings including design (Bruce et al., 2002), education (Hyldegard, 2004), and military command and control (Sonnenwald & Pierce, 2000). We define collaborative information seeking (CIS) as “an information access activity related to a specific problem solving activity that, implicitly or explicitly, involves human beings interacting with other human(s) directly and/or through texts (e.g., documents, notes, figures) as information sources in an work task related information seeking and retrieval process either in a specific workplace setting or in a more open community or environment.” (Hansen & Jarvelin, 2005).

We have been investigating the CIS behavior of teams in the context of hospital work (Reddy and Dourish, 2002, Reddy et al., 2002b). Although a number of organizational settings involve teams and team work, few settings are as rich in detail as hospitals (Bardram, 2000). Because of the increasing complexity of patient conditions and treatments, hospitals are turning to patient care teams as a means of managing their patient population. These teams are highly multidisciplinary – consisting of physicians, nurses, pharmacists, physical therapists, and other healthcare workers (Gorman et al., 2000). Similar to teams in other settings (Fidel et al., 2000), a patient care team brings together healthcare workers with different backgrounds and expertise to focus on a single patient and the patient’s problems. Although each team member may have different concerns, work, and motivations (Strauss, Fagerhaugh, Suczek, & Wiener, 1985), they must collaborate and coordinate their activities to provide effective patient care.

In particular, we conducted an ethnographic field study of CIS behavior of a multidisciplinary patient care team in an emergency department (ED) of a small rural hospital. The ED is, arguably, one of the most information-intensive and collaborative settings in a hospital. In addition, team members in the ED often work under tremendous time pressure because of the critical status of the patients and the need to treat all waiting patients.

In this environment, team members face numerous challenges to finding needed information in order to provide effective patient care. First, patient information is often located in multiple resources. For instance, the digital images may be in one resource and the lab results in another resource. Therefore, team members must find all the different pieces of information and weave them together. Second, they must quickly treat patients because of the constant backlog of waiting patients. Thus, they need to find information as rapidly as possible. Finally, team members cannot afford to make mistakes so they must insure that the information they use is accurate. Because of these challenges, collaboration during information seeking activities is an integral aspect of the work in the unit.

Through the field study, we were interested in answering two research questions: (1) what are the information needs of the multidisciplinary patient care team? (2) What triggered their CIS activities? By answering those two questions, we hope to gain a better understanding of CIS behavior. The paper is organized as follows: in the next section, we provide some background about collaborative information seeking. In section 3, we describe our research methods and study site. We then present results from our field study in Section 4. Section 5 discusses information breakdown and needs, CIS behavior, and consequences of CIS activities. We also discuss organizational and technical recommendations for supporting collaborative information seeking behavior. Finally, we conclude with remarks about collaboration, information seeking, and work.

Section snippets

Background

Although information seeking is viewed as an important aspect of collaborative work activities (Cicourel, 1990, Hansen and Jarvelin, 2005, Paepcke, 1996), there has been only limited research in understanding CIS behavior.

Most current research in CIS behavior has focused on understanding how team members collaborate during information seeking activities. The most extensive study of CIS to date has been conducted by a team of researchers from the University of Washington (Bruce et al., 2003,

Emergency Department of Regional Hospital

The ED at Regional Hospital is a 25-bed unit that treats people suffering from a wide range of illnesses. The unit is particularly busy because it is the only major ED in a thirty mile radius. It deals with everything from children with fevers to severe motor vehicle accident victims. Most days, the ED team sees approximately 80 patients, but often more than 100 patients per day in the winter months. The unit is staffed 24 h per day by a team of specially trained healthcare professionals. In

The work in the ED

To provide an understanding of the collaborative ED environment, we briefly describe the objectives and primary goals of the ED patient care team.

The ED is often a patient’s first introduction to the healthcare system and is a quintessential example of a high-reliability organization (Weick & Roberts, 1993). In these organizations, errors cannot be tolerated because of the extreme consequences of the mistakes. In the ED, a mistake can lead to the death of a patient. Therefore, the ED team must

Results

The challenges of problem identification and surge management in the information-intensive, rapidly paced environment of the ED require team members to work together. One important aspect of that work is identifying and satisfying their information needs as they arise during their activities. Much of the work in the unit deals with quickly gathering relevant pieces of information to make and implement decisions. In this environment, team members must often work together to find needed

Discussion

Our fieldwork highlighted team information needs in the ED and triggers for CIS activities. We now turn our attention to discussing what creates the information needs in the ED, how team members interact when searching for information, the primary sources of information in the unit, and the consequences of CIS activities in workplaces. We end our discussion with a few organizational and technical implications for supporting CIS behavior.

Conclusion

In our study in the ED, we found that team members have both organizational and clinical information needs, that their information needs often arose from breakdowns in the information flow in the unit, and that specific situations triggered collaborative information seeking activities. Although information needs can be expressed in a number of different ways, we found that team members asked questions when they did not have needed information. Our investigation of collaborative information

Acknowledgement

We would like to thank the ED physicians, nurses, pharmacists, and other staff members for allowing us to observe and interview them.

Madhu Reddy is an assistant professor in the College of Information Sciences and Technology at The Pennsylvania State University – University Park. His research interests focus on information seeking and use, collaboration, and health care teams.

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  • Cited by (0)

    Madhu Reddy is an assistant professor in the College of Information Sciences and Technology at The Pennsylvania State University – University Park. His research interests focus on information seeking and use, collaboration, and health care teams.

    Patrica Ruma Spence is a doctoral student in the College of Information Sciences and Technology at The Pennsylvania State University – University Park. Her research focuses on collaborative information seeking behavior of multidisciplinary teams.

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