Human Factors Techno- logy Medicine 2009 © Xiao, UM Basic Concepts and Theories of Coordination and Planning – Systems View Objectives: To understand –The global perspectives of coordination –New frontiers of coordination research

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination: What it is

Human Factors Techno- logy Medicine 2009 © Xiao, UM

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination: Scales and Perspectives Temporal scales –Seconds/minutes –Hours/shifts –Weeks/months –Years Org scales –Individuals/groups –Teams/work units –Organization –Industry Perspectives –“Mechanical”: articulation & concatenation –Social: willingness to work together –Artifacts: supporting tools –Organizational: models of firms

Human Factors Techno- logy Medicine 2009 © Xiao, UM Relevant Disciplines Cognitive psychology: eg, human planning, monitoring, problem solving Computer support cooperative work: eg, groupware, mediated communication, common information space Team performance: eg, shared mental models, crew resource management, leadership, team coordination Scheduling and workflow: eg, constraints, slacks, sensitivity analysis Organizational behavior: eg, culture, norms, standard operating procedures

Human Factors Techno- logy Medicine 2009 © Xiao, UM Examples of Problems in Healthcare Management of surgical operating rooms Management of intensive care unit resources (“bed management”) Flows in emergency department High intensive situations, such as high risk child birth, surgery, resuscitation Hand-offs Care coordination for chronic diseases

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about managing interdependencies Coordination is managing dependencies between activities ( E.g., Malone & Crowston, 1994 ) –Major types of dependencies Shared resources (resource allocation) Prerequisite constraints (sequencing) Simultaneity constraints (synchronization)

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about process management “To many it seems as if the classical theory and real industrial problems reside in quite different worlds.” “In practice planning and scheduling do not come packaged as discrete problems that can be ‘solved’, optimally or otherwise. Rather they are dynamic processes that need to be managed over time. People, individual or teams manage the processes.” BL MacCarthy & J Welson, 2001

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination for a case start-time

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about information Monitoring deviations Identifying threats and opportunities Understanding intentions of others Monitoring activities of others Establishing “common grounds”

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about anticipatory behaviors

Human Factors Techno- logy Medicine 2009 © Xiao, UM Xiao et al, 1997

Human Factors Techno- logy Medicine 2009 © Xiao, UM Xiao et al, 1997

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about sharing mental models Sharing strategies and concerns is part of coordination to promote anticipatory behavior Team briefing/debriefing

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about resolution of conflicts Establishing consensus of norms and expectation Maintaining credibility Negotiating priorities Assigning accountability

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about multiple levels of control Using both feedforward and feedback control Resolving mutual information needs on –Timing –Specification of tasks –Goals and priorities –Procedures for resolving exceptions

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination is about relations (not just information) Inter-personal relations can be the foundation of information sharing as a human activity (relational coordination) –Coordination carried out through relationships of Shared goals –Subgoal versus overall work process Shared knowledge –Input/output requirements Mutual respect –Considering impact of their actions Gittell, 2002, Management Science

Human Factors Techno- logy Medicine 2009 © Xiao, UM Summary Coordination is about –managing interdependencies –process management –information –anticipatory behaviors –sharing mental models –resolution of conflicts –relations (not just information) –multiple levels of control

Human Factors Techno- logy Medicine 2009 © Xiao, UM

Human Factors Techno- logy Medicine 2009 © Xiao, UM Southwest’s Culture is Focused on Relationships Southwest’s most distinctive organizational competency is its ability to build and sustain relationships characterized by –Shared goals –Shared knowledge –Mutual respect Focus on relationships is the fundamental driver of leadership, culture, strategy, and coordination at Southwest (Gittell, 2003) Jim Messina, Ph.D

Human Factors Techno- logy Medicine 2009 © Xiao, UM Impact of Strong Relationships at Southwest Employees embrace their connections with one another Which allows them to coordinate more effectively across all functions (Gittell, 2003) “We at Southwest Airlines foster and embrace fun, creativity, individuality, and empowerment. We love our employees. We trust our employees.” (West, 2005)“We at Southwest Airlines foster and embrace fun, creativity, individuality, and empowerment. We love our employees. We trust our employees.” (West, 2005) Jim Messina, Ph.D

Human Factors Techno- logy Medicine 2009 © Xiao, UM Impact of Shared Goals at Southwest Motivates individuals to move beyond what is best for their own narrow area of responsibility within their own function Motivates them to to act in the best interests of the overall process of the organization and lessens competition between different functions within the organization (Gittell, 2003) (West, 2005)“Hire People who can Laugh at themselves.” (West, 2005) Jim Messina, Ph.D

Human Factors Techno- logy Medicine 2009 © Xiao, UM Impact of Shared Knowledge at Southwest Shared knowledge at Southwest is about how the tasks of one person or group are related to all other tasks This enables the workforce to act with regard for the total process This enables the workforce to be more competent, efficient and coordinated than their competitors (Gittell, 2003) “The philosophy at Southwest has always been, ‘Never forget where you came from’.” (West, 2005)“The philosophy at Southwest has always been, ‘Never forget where you came from’.” (West, 2005) Jim Messina, Ph.D

Human Factors Techno- logy Medicine 2009 © Xiao, UM Impact of Respect for Others at Southwest Encourages all employees to value the contributions of their colleagues Encourages all employees to consider the impact of their actions on others Reinforces the tendency to act in the best interests of the overall work process (Gittell, 2003) Jim Messina, Ph.D

Human Factors Techno- logy Medicine 2009 © Xiao, UM

Human Factors Techno- logy Medicine 2009 © Xiao, UM Coordination: Sample Research Questions What are the information needs for coordination? How is coordination achieved? How to support coordination?

Human Factors Techno- logy Medicine 2009 © Xiao, UM Concepts Useful for Observations Distributed cognition (Hutchins) –Unit of analysis is work systems, not individuals (e.g., humans + their tools) Common information space (Bossom) –Implicit communication achieved through sharing (e.g., whiteboard) Awareness (Dourish) –Information about activities of others should be provided in the peripheral without explicit efforts of asking Trajectory (Strauss) –Expertise in anticipating temporal courses of events is key for anticipatory behaviors

Human Factors Techno- logy Medicine 2009 © Xiao, UM Fundamentals of observations Goals of observations –Evaluation, design requirements Tools of observations –Time & motion (e.g., distributions of activities) –Task analysis (e.g., purposes of activities) –Link analysis (e.g., sequence of activities) Biases and limitations of observations –Sampling, interference, time-consuming Theoretical perspectives : know your “units” and “objects”

Human Factors Techno- logy Medicine 2009 © Xiao, UM Video Analysis Methodology Task templates Thematic analysis Time-motion studies Communication analysis

Human Factors Techno- logy Medicine 2009 © Xiao, UM Model 30 Farbod N. Hagigi

Human Factors Techno- logy Medicine 2009 © Xiao, UM National Trauma Center IT Survey Description of field-hospital communication related information technology Field communication accuracy and completeness Intra-hospital expertise coordination Trauma team organizations and culture

Human Factors Techno- logy Medicine 2009 © Xiao, UM Respondents Settings: 456 Level I and Level II Trauma Centers in the US Subjects –145 hospitals completed sets of survey (1 director, 1 coordinator, and > 2 clinicians) –1233 respondents from 308 hospitals 254 Trauma Directors 212 Trauma Coordinators 767 Trauma Clinicians from 207 hospitals

Human Factors Techno- logy Medicine 2009 © Xiao, UM IT Devices for Alerting The Trauma Team by Admission Volume %

Human Factors Techno- logy Medicine 2009 © Xiao, UM Summary Qualitative methods can be very effective in theorizing about coordination Surveying through questionnaires may be useful in understanding mechanisms of coordination