| Information flow within medical environments is ubiquitous and is essential for the coordination and collaboration among spatially and temporally distributed multidisciplinary clinicians for achieving work. Thus, in order to provide the best possible healthcare to patients, nurses working in different shifts must work collaboratively to ensure all the necessary information is communicated so that patient care can be carried on properly.;In order to apply the knowledge gained through these studies to the development of technologies for a more seamless and less obtrusive fit into the working environment, the results of the observational studies were combined with past literature to inform the development of a conceptual framework for nurses' information flow. This framework is useful for evaluating the impact of new technologies on information flow and for generating new technology designs. This resulted in the development of a technology prototype which I then evaluated through a focus group of practising nurses who indicated promising potential of an integrated charting approach bridging the nurses' use of paper personal notes and the organizational deployment of digital medical records. The insights gained from this investigation led to the development of a refined set of design guidelines for developing technologies to support nurses' information flow practices.;In this dissertation, I investigate the work practices in use, observing how they are exercised during nurses' information flow, and how they are impacted by new technologies. To gain a good understanding of nurses' actual work practices that have been developed over years of experience, an in-depth observational study was conducted. This study provides a set of benchmark work practices for comparison and contrast when new technologies are deployed. While digital solutions have been replacing paper medical records to provide more consistent, integrated, distributed, and timely sharing of information, current information systems were found to fall short in supporting daily clinical practices due to its fragmented, hierarchical structure. Besides, many technological candidates to replace paper, such as Tablet PCs or PDAs, seem to fall short due to their constrained interfaces, indirect forms of input (mouse and keyboards), inability to share multiple documents concurrently, and failure to support "writing-as-thinking". |
