Situation awareness amongst emergency care practitioners

The increase and changes in the demand for emergency care require pro-active responses from the designers and implementers of the emergency care system. The role of Emergency Care Practitioner (ECP) was introduced in England to improve the delivery of emergency care in the community. The role was evaluated using cost-benefit approach and compared with other existing emergency care roles. An analysis of the cognitive elements (situation awareness (SA) and naturalistic decision making (NDM)) of the ECP job was proposed considering the mental efforts involved. While the cost-benefit approach can justify further spending on developing the role, a cognitive approach can provide the evidence in ensuring the role is developed to fulfil its purpose. A series of studies were carried out to describe SA and NDM amongst ECPs in an ambulance service in England. A study examined decision-making process using Critical Decision Method interviews which revealed the main processes in making decision and how information was used to develop SA. Based on the findings, the subsequent studies focus on the non-clinical factors that influence SA and decision making. Data from a scoping study were used to develop a socio-technical systems framework based on existing models and frameworks. The framework was then used to guide further exploration of SA and NDM. Emergency calls that were assigned to ECPs over a period of 8 months were analysed. The analysis revealed system-related influences on the deployment of ECPs. Interviews with the ECPs enabled the identification of influences on their decision-making with respect to patient care. Goal-directed task analysis was used to identify the decision points and information requirements of the ECPs. The findings and the framework were then evaluated via a set of studies based on an ethnographic approach. Participant observations with 13 ECPs were carried out. Field notes provided further insight into the characteristics of jobs assigned to the ECPs. It was possible to map the actual information used by the ECP to their information needs. The sources of the information were classified according to system levels. A questionnaire based on factors influencing decision-making was tested with actual cases. It was found that the items in the questionnaire could reliably measure factors that influence decision-making. Overall, the studies identify factors that have direct and indirect influences on the ECP job. A coherent model for the whole emergency care systems can be developed to build safety into the care delivery process. Further development of the ECP role need to consider the support for cognitive tasks in light of the findings reported in this thesis

A Finite State Automaton Representation And Simulation Of A Data/Frame Model Of Sensemaking

This thesis presents the application of a finite state automaton (FSA) to analytic modeling of Data/Frame Model (DFM) of sensemaking. A FSA is chosen for the DFM simulation because of its inherent characteristics to mimic changes in system behaviors and transitional states akin to the dynamic information changes in dynamic and unstructured emergencies. It also has the ability to capture feedback and loops, transitions, and spatio-temporal events based on iterative processes of an individual or a group of sensemakers. The thesis has exploited the human-driven DFM constructs for analytical modeling using Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW) software system. Sensemaking times, problem stage time (PST), and nodeto-node (NTN) transition times serve as the major performance factors. The results obtained show differences in sensemaking times based on problem complexity and information uncertainty. An analysis of variance (ANOVA) statistical analysis, for three developed fictitious scenarios with different complexities and Hurricane Katrina, was conducted to investigate sensemaking performance. The results show that sensemaking performance was significant with an F (3,177) of 16.78 and probability value less than 0.05, indicating an overall effect of sensemaking information flow on sensemaking. Tukey’s Studentized Range Test shows the significant statistical differences between the complexities of Hurricane Katrina (HK) and medium complexity scenario (MC), HK and low complexity scenario (LC), high complexity scenario (HC) and LC, and MC and LC

From Common Operational Picture to Common Situational Understanding : A Framework for Information Sharing in Multi-Organizational Emergency Management

Complex emergencies such as natural disasters are increasing in frequency and scope, in all regions of the world. These emergencies have devastating impacts on people, property, and the environment. Responding to these events and reducing their impact requires that emergency management organizations (EMOs) collaborate in their operations. Complex emergencies require extraordinary efforts from EMOs and often should be handled beyond ordinary routines and structures. Such operations involving multiple stakeholders are typically characterized by inadequate information sharing, decision-making problems, limited situational awareness (SA), and lack of common situational understanding. Despite a high volume of research on these challenges, evaluations from complex disasters and large-scale exercises document that there are still several unsolved issues related to information sharing and the development of common situational understanding. Examples here include fulfillment of heterogeneous information needs, employment of different communication tools and processes with limited interoperability, and information overload resulting from a lack of mechanisms for filtering irrelevant information. Multi-organizational emergency management is an established area of research focusing on how to successfully collaborate and share information for developing common situational understanding. However, the level of complexity and situational dependencies between the involved EMOs create challenges for researchers. An important element for efficient collaboration and information sharing is building and maintaining a common operational picture (COP). Sharing important information is a key element in emergency management involving several EMOs, and both static and dynamic information must be accessible to perform tasks effectively during emergency response. To be proactive and mitigate the emergency impacts requires up-to-date information, both factual information via the COP and the ability to share interpretations and implications through using a communication system for rapid verbal negotiation. The overall research objective is to investigate how stakeholders perceive and develop SA and COP, and to explore and understand key requirements for stakeholders to develop a common situational understanding in complex multi-organizational emergency management.publishedVersio

Ordering Networks: Motorways and the Work of Managing Disruption

This thesis contributes to a new understanding of the motorway network and its traffic movements as a problem of practical accomplishment. It is based on a detailed ethnomethodological study of incident management in the Highways Agency’s motorway control room, which observes the methods operators use to detect, diagnose and clear incidents to accomplish safe and reliable traffic. Its main concern is how millions of vehicles can depend on the motorway network to fulfil obligations for travel when it is constantly compromised by disruption from congestion, road accidents and vehicle breakdowns. It argues that transport geography and new mobilities research have overlooked questions of practical accomplishment; they tend to treat movement as an inevitable demand, producing fixed technical solutions to optimise it, or a self-evident phenomenon, made meaningful only through the intensely human experience of mobility. In response, the frame of practical accomplishment is developed to analyse the ways in which traffic is ongoingly organised through the situated and contingent practices that take place in the control room. The point is that traffic does not move by magic; it has to be planned for, produced and persistently worked at. This is coupled with an understanding of network topology that reconsiders the motorway network as always in process by virtue of the materially heterogeneous relations it keeps, drawing attention to the intensely collaborative nature of work between operators and technology that permits the management of disruption at-a-distance and in real time. This work is by no means straightforward – the actions of monitoring, detecting, diagnosing and classifying incidents and managing traffic are revealed to be complexly situated and prone to uncertainty, requiring constant ordering work to accomplish them. In conclusion, this thesis argues for the frame of practical accomplishment to be taken seriously, rendering the work of transport networks available for sustained analysis

112.social: Design and Evaluation of a Mobile Crisis App for Bidirectional Communication between Emergency Services and Citizens

Emergencies threaten human lives and overall societal continuity, whether or not the crises and disasters are induced by nature, such as earthquakes, floods and hurricanes, or by human beings, such as accidents, terror attacks and uprisings. In such situations, not only do citizens demand information about the damage and safe behaviour, but emergency services also require high quality information to improve situational awareness. For this purpose, there are currently two kinds of apps available: General-purpose apps, such as Facebook Safety Check or Twitter Alerts, already integrate safety features. Specific crisis apps, such as KATWARN in Germany or FEMA in the US, provide information on how to behave before, during and after emergencies, and capabilities for reporting incidents or receiving disaster warnings. In this paper, we analyse authorities’ and citizens’ information demands and features of crisis apps. Moreover, we present the concept, implementation and evaluation of a crisis app for incident reporting and bidirectional communication between authorities and citizens. Using the app, citizens may (1) report incidents by providing a category, description, location and multimedia files and (2) receive broadcasts and responses from authorities. Finally, we outline features, requirements and contextual factors for incident reporting and bidirectional communication via mobile app

Data Census of a Geographically-Bounded Tweet Set to Enhance Common Operational Picture Tools

Location information is of particular importance to crisis informatics. The Twitter API provides several methods to assess a rough location and/or the specific latitude and longitude in which a post originated. This paper offers a comparison of location information provided by Twitter’s four geolocation methods. The study aggregates one month of data from the greater Cincinnati, Ohio metropolitan area and assesses the relative contribution that each method can make to common operational picture tools used by crisis informatics researchers. Results show that of 49,744 Tweets, 4% contained geotags, 85.2% contained a location in the users’ profile, and 3.5% contained no apparent location data, but were gathered using the bounding box method and would not have been identified using traditional methods of gathering data using geotagged Tweets or user profile information alone. We reflect on these results in light of design implications for common operational picture tools (COPs)

"It is Not Because You Have Tools that You Must use Them"

International audienceWe conducted a retrospective study on the experimental deployment of a telemedicine toolkit in ten nursing homes. The purpose of the experiment was to see whether the use of these toolkits could allow for better cooperation between nursing homes and the local emergency medical dispatch center to avoid sending costly vehicles and having elderly people unnecessarily discharged at the hospital. We investigated the domestication process of these toolkits by nurses and orderlies from the nursing homes. Our findings show different levels of domestication: for some of the nursing homes, the lack of practical relevance of the toolkit in emergencies and the difficulty to borrow artifacts from doctors prevented complete adoption. For three nursing homes, domestication occurred in an unexpected way in the sense that the objective of the domestication changed. These findings led us to provide recommendations for projects aimed at improving inter-organizational cooperation through artifacts

112.SOCIAL: Design and Evaluation of a Mobile Crisis App for Bidirectional Communication between Emergency Services and Citizen

Emergencies threaten human lives and overall societal continuity, whether or not the crises and disasters are induced by nature, such as earthquakes, floods and hurricanes, or by human beings, such as accidents, terror attacks and uprisings. In such situations, not only do citizens demand information about the damage and safe behaviour, but emergency services also require high quality information to improve situational awareness. For this purpose, there are currently two kinds of apps available: General-purpose apps, such as Facebook Safety Check or Twitter Alerts, already integrate safety features. Specific crisis apps, such as KATWARN in Germany or FEMA in the US, provide information on how to behave before, during and after emergencies, and capabilities for reporting incidents or receiving disaster warnings. In this paper, we analyse authorities’ and citizens’ information demands and features of crisis apps. Moreover, we present the concept, implementation and evaluation of a crisis app for incident reporting and bidirectional communication between authorities and citizens. Using the app, citizens may (1) report incidents by providing a category, description, location and multimedia files and (2) receive broadcasts and responses from authorities. Finally, we outline features, requirements and contextual factors for incident reporting and bidirectional communication via mobile app

Effective Use of Information Systems for Emergency Management: a Representation Theory Perspective

Effective Use Theory (EUT) has emerged as a promising native Information Systems (IS) theory to understand a central phenomenon of interest to the discipline: the effective use of information systems. While EUT is widely accepted in operational control and management control contexts, its validity in chaotic environments has yet to be demonstrated. To contribute to the research program in EUT, scholars called for contextualizing and assessing EUT in chaotic environment, such as emergencies or crises events. This research seeks to apply EUT to understand the effective use of emergency information systems (EMIS). Seeking a grand theory of effective use in EMIS helps the onset of a structured research program and the development of a cumulative research tradition. That fosters EMIS as a would-be reference discipline for cross-disciplinary scholarship in emergency management. Moreover, assessing EUT in the edge context of emergencies, contributes to theory development by problematizing on assumptions that scholars have been considering unproblematic