Information Handover in Time-Critical Work

Abstract

Information transfer under time pressure and stress often leads to information loss. This paper studies the characteristics and problems of information handover from the emergency medical services (EMS) crew to the trauma team when a critically injured patient arrives to the trauma bay. We consider the characteristics of the handover process and the subsequent use of transferred information. Our goal is to support the design of technology for information transfer by identifying specific challenges faced by EMS crews and trauma teams during handover. Data were drawn from observation and video recording of 18 trauma resuscitations. The study shows how EMS crews report information from the field and the types of information that they include in their reports. Particular problems occur when reports lack structure, continuity, and complete descriptions of treatments given en route. We also found that trauma team members have problems retaining reported information. They pay attention to the items needed for immediately treating the patient and inquire about other items when needed during the resuscitation. The paper identifies a set of design challenges that arise during information transfer under time pressure and stress, and discusses characteristics of potential technological solutions.