What’s bothering developers in code review?

The practice of code review is widely adopted in industry and hasbeen studied to an increasing degree in the research community.However, the developer experience of code review has receivedlimited attention. Here, we report on initial results from a mixed-method exploratory study of the developer experience

Can journey mapping be used to visualize information sharing in home care?

This study investigates the use of journey mapping as a tool for visualizing theflow of information in home care. Journey mapping is a design method with the purpose of visualizing the interaction of a user and a product or service. It tries to encompass the whole user experience including actions and touch points between user and product, feelings and other related information. Hence, the visualized journey in a journey map is originally from one persons’ perspective. Here we will instead emanate from the perspective of the information, and draw the journey map based on different pieces of information, using a set of concrete scenarios from home care. The aim is to get a better understanding of how information flows in the home care setting, and the journey map will be a useful tool in the process of developing home care further. This can for example be in the process of designing digital support systems, for designing the information itself, or for developing work routines around the information

Teamarbete på operationssal, organisationsdesign och patientsäkerhet

Teamarbete är vanligt inom hälso- och sjukvården. I mitt avhandlingsarbete har jag studerat teamarbete på operationssal med fokus på hur det praktiska arbetet faktiskt går till. Avhandlingens delstudier berör sådant som den praktiska användningen av formella rutiner (WHOs checklista för säker kirurgi), ledarskap på operationssal, olika professioners syn på det gemensamma arbetet, testning av en metod för att förbättra arbetet, samt riktlinjer för hur man kan organisera för teamarbete. Resultaten visar bl.a. på variation i följsamhet mellan frågor på checklistan vilket leder till nya frågeställningar. Resultaten visar också på att ledarskapet är något som distribueras över hela teamet i operationssalen. Stabilare team, tillfällen till kommunikation samt ett flexibelt ledarskap, lyfts fram som organisatoriska principer som främjar teamarbete

Safety-II and the study of healthcare safety routines : Two paths forward for research

Safety routines such as the WHO surgical safety checklist and SBAR have gained widespread attention and implementation in healthcare. However, there has also been criticism. With the ongoing Covid-19 pandemic, the need for knowledge about how safety routines work in practice is larger than ever. In light of these obstacles, I suggest two approaches to the study of healthcare safety routines, based on a human factors perspective and a safety II mind-set that so far has gained little attention. The WHO surgical safety checklist, is used as an example. However, the suggestions presented here applies to other safety routines as well. The first approach is that instead of being preoccupied with what people do not do, investigate what they value with the routine. The perceived importance of different parts of the routine can expose the rationality behind the personnel's choice of actions when using the routine. Knowledge that could be used both to investigate the dynamics of everyday performance and for redesign and adjustment of the routine. The second approach is that instead of looking for failure, investigate and highlight when the routine works. Examples of when the routine works, i.e. avert adverse events, can be used both as positive reinforcement, and as an opportunity for learning with regards to everyday performance variability. Since a safety-II perspective is largely missing in the literature on healthcare safety routines, the two approaches suggested here comes with a huge potential for learning about how to improve safety

Teamwork in the operating room - The role of organizational design and implications for patient safety

The topic of this thesis is teamwork in healthcare. Healthcare is often described as complex. This description is more appropriate now than ever with the extensive specialization that has taken place in recent decades resulting in increasingly specialized physicians and nurses. While this specialization has made it possible to cure even sicker patients, it has also resulted in less overlapping knowledge and thus larger gaps between the different specialties’ areas of expertise. The method prescribed to overcome these challenges is often interprofessional teamwork. It is almost taken for granted that teamwork can make healthcare more efficient and that it is important for patient safety. Surgery in the operating room is an area where this is particularly prevalent. In the operating room anesthesiologists, anesthetist nurses, circulating nurses, scrub nurses and surgeons meet together as a team, in different constellations, to provide surgery for the patient. This thesis is concerned with the interprofessional team in the operating room, on how team members understand their common work, on how they concretely work together, and on how their practice and teamwork capabilities can be improved through organizational means. The thesis consists of five studies. The main methods used to collect data are interviews and observations using video. The video observations consisted of surgical procedures and group meetings. Depending on the purpose, the analysis of video data differed from more open exploratory bottom-up methodologies to top-down approaches, such as the usage of predefined observation protocols. The results indicate that the operating team is not as cohesive as might be assumed and that contradicting rationalities held among team members from different professions can at times result in tension in the team. A complementary alternative to the popular team training approach to improve teamwork is suggested in organizing for teamwork. The three organizational principles of team stability, occasions for communication and an adaptive approach to leadership are identified as important in order to organize for teamwork. As teamwork is associated with patient safety, this can potentially have implications for patient safety as well. The results also show that a popular routine to improve patient safety, the WHO Surgical Safety Checklist, is not actually used in reality as prescribed in the routine. This can lead to new risks if its correct usage is taken for granted and other behaviors are adapted accordingly. The perceived importance of different Checklist items and the conception of risk among its users should be considered in future efforts to improve Checklist usage. It is also shown that leadership in the operating room is distributed rather than something associated with a specific leader. This challenges traditional leader-centered perspectives on leadership in the operating room. An action oriented group method to facilitate organizational development and innovation was tested at the operating unit. The results show that the method worked well in the group and that the group managed to initiate a successful change project, but that the group’s anchoring at their organizational unit should be ensured. The studies in which this thesis is based show that practice in the operating room does not always look as expected. Methodologically, this means that methods that are capable of capturing the actual practice, such as observations, are valuable tools when studying complex healthcare settings, such as work in an operating room

A Study of a Hospital Operating Unit as a Foundation for Future Improvements

The main objective of the research presented was to gain an understanding of how the dynamics between professionals, tools and objectives work in an operating unit in order to obtain knowledge useful when designing the operating unit of the future with emphasis on the work environment, effectiveness and patient safety. By investigating how different professions in the operating theatre view their work and its dynamics, as well as observing how the work is actually carried out, it is possible to get a conception of the dynamics and motives that determine how the work is constituted. This research explores how different professions view their work by means of an interview study, and how the work is carried out in practice by means of a direct observation study. Together, the results of the studies provide two different perspectives on operating theatre work. In both studies, the perspectives of the professionals play an important role. How something is perceived influences how we decide to act. To increase the potential for improvement, widening those perspectives plays a central role. By doing so, the practice will in turn appear more complex to the practitioners; there will be more aspects to take into consideration. More contradictions and options will be visible. To improve the practitioners’ capability to handle this increased complexity, trust is identified as an important tool. Trust is a mechanism that can suspend doubt or complexity in such a way that it is possible to make effective decisions even when the number of options is too large to handle. Previous research indicates that surgical teams are not as cohesive as could be expected and that communication failures frequently occur in the operating theatre. The first study presented in this thesis elaborates on how this can come about. It investigates how different healthcare professions in the surgical team orientate themselves towards their task and how this can be affected by the organizational and social context. Virtual reality supported semi-structured interviews were conducted with 15 participants recruited from all personnel categories of the surgical team. Activity theory was used as a theoretical framework to analyze the interviews. The results indicated that poor team functionality to some degree can be explained by different activity orientations between professions, which leads to different views on work activities and tension between them. Social and organizational support structures in the daily practice are pointed out as a means to facilitate trust and experience sharing between professions. This can promote the establishment of a common view among different professionals in the operating team and increase interprofessional communication, hence overcoming communication thresholds in the operating theatre. To improve safety in the operating theatre, checklists have gained considerable support in recent years, often in the form of a pre-operative timeout. The World Health Organization (WHO) has developed its own timeout checklist, which has been adopted by several Swedish operating units. Previous research indicates that timeout checklists reduce complications from surgery and can even improve the safety attitude of the team members. Thus, the effects of the checklist have been studied, but little research has been carried out on how the checklist is actually used in practice. This is investigated in the second study included in this thesis to determine how the surgical team uses and relates to the checklist as well as to identify and explain deviations from it. Twenty-four timeout procedures of four different, but common, operations were video recorded and analyzed according to a predefined protocol based on the WHO checklist instructions. The results showed that compliance varied between questions. The questions with the best compliance appeared to be the ones that made the most sense and were perceived as the most important by the participants. In half of the observed procedures, personal presentations did not occur and in five of those cases, they were postponed. This indicates that these questions, intended to facilitate communication between team members, were not perceived as contributing to patient safety in any meaningful way. The results also showed that surgeons and anesthesiology personnel dominated much of the timeout. It is likely that the positive effects on patient safety attributed to the checklist can be improved by making the connection between the checklist, communication and teamwork more explicit and by altering the checklist so that the different professions more equally involved

Organisation och Åtkomst av Filer : En Explorativ Studie av Datoranvändare ur ett Psykologiskt Perspektiv

Syftet med denna studie var att få bättre förståelse för hur datoranvändare organiserar filer och att få ökad förståelse för vilka vägar datoranvändare väljer för att komma åt filer i ett datorsystem designat efter skrivbordsmetaforen. Resultatet tolkas utifrån aktivitetsteori och distribuerad kognition samt tidigare forskning. Halvstrukturerade intervjuer gjordes med 18 datoranvändare i den ordinarie arbetsmiljön. Utöver att svara på frågor fick de också visa och förklara hur de organiserat sina filer samt hur de gick tillväga när de använde dem. Resultatet pekar på en betydande ökning i användning av datorns skrivbord jämfört med tidigare studier. Två typer av lagrad information kunde identifieras, temporär och långvarig. Ur resultatet framgår också att aktivitetsbaserade dokumenthanteringssystem fungerar dåligt eftersom kontexten för aktiviteten är allt för komplex