How to separate the trees from the forest – The workplace as a Swiss army knife

Continuing on the “forests and trees” metaphor from a previous post we will now see what happens when you try to separate the trees from each other. So, let us start with one single tree (or task). One tree does not make a forest, but it can very easily be distinguished as a tree of a certain kind. A Pine tree has long needles; A fir tree has short needles. And a tree without needles is a leafy tree (unless it is a Gingko tree, but that is another story).  However, once there are more trees in a lump, the categorisation becomes more difficult. 

Transferred to the issue of work and tasks: As long as we are only doing one single task or having one single role, it is also quite simple to see and study it, and also (at least to some extent) to understand how it works, and what the consequences are. This is not to say that this kind of work is simple or uncomplicated, a heart transplant is a complicated task, even though it is a single task and well specified at that. We may also still make design mistakes on this single task design, but these kinds of mistakes are mostly confined to the task environment we work in at the moment. 

In a way, as long as we have many instances of the same type of single tasks that we can handle more or less sequentially, we are still proceeding through something, which in the forest metaphor is like a well-managed orchard with the same kind of trees planted spaciously and in neat rows. We can still handle the situation with the same kind of specialised tools, and the tools may also have an easier way to communicate with each other, e.g., using the same terminology, the same data formats etc. since they are designed for the same task.

Now, when we consider the work situation for nurses at a hospital ward explicitly, their situation is completely different. Their work more or less constitutes the very definition of “fragmented work tasks”. First, there is planned fragmentation, where the person has to change tasks or responsibilities according to a schedule. Second, there are interrupting tasks in terms of alarms, visiting relatives, telephone calls and other randomly occurring events that also cause a fragmented work situation. There is a related blog post by Åsa Cajander “On Digitalisation and Fragmentation of Time” about this phenomenon.  

The interruptions that occur over a work day can have at least two major effects on the nurse. He or she has to switch context for the work, which in itself is a stressing action for the brain. In the case of sudden intruding tasks, there is also the problem of mentally going back to the interrupted task and continue from where it was discontinued, sometimes after many hours. This situation becomes almost, again in the forest analogy, like looking at a primeval forest or a rainforest. There are trees everywhere and of every kind, and they are all interconnected in some ways. You need both stamina and focus in order to find your way through the forest/work. 

This becomes even more problematic when we look at the computer support for work tasks in any workplace. The general computer system is in many cases designed in the same way as a Swiss Army knife. We use the same technical framework for all the tasks that should be performed, using a keyboard, a mouse (or a mousepad) and a screen for the stationary tasks, and mobile apps, in the best case redesigned for the smaller screens of mobile devices, for the tasks that are done on the run. Journal entries, medication dosage calculations, and many planning tasks are therefore performed in the same limited cognitive space, and there is no real support for the switching between those tasks, nor for the fragmentation of the ongoing work. 

In some cases, like writing down the notes for the daily ward round, the information is even taken down as hand-written jots on a paper form and has to be transferred manually into the journal later. 

A Swiss army knife is not really perfect in any of its functions (even the knife blade leaves a lot to be desired), it still works, and someone who is not a carpenter, mechanic or plumber might even think it is a good and practical tool. But for any professional, if asked, they would definitely prefer to use a specialized tool. Apart from being more efficient, specialized tools also pose a lower risk of accidents and slips. In the same way, non-specialized computer tools may, even though they can perform the desired tasks, still not be the best choice in a complex work situation.

When we design new computer systems for organizations like hospital wards, schools, etc. they are often positioned around one task at a time. We study one tree at a time in the forest. Even though we are much better off than at the beginning of the PC era, when we could only run one program at a time, we are still running several parallel processes that interconnect badly, if at all. 

During the study visit at Akademiska in Uppsala last year (the university hospital in Uppsala), I found ten different systems used in one of the wards, all running on the “same computer”. This amounts to having ten tools on the Swiss army knife. Of course, the individual programs are in some way specialized. We don’t use spreadsheets for everything. Each separate task has applications or programs that are explicitly designed for its purpose but not for the whole entangled web of work tasks. Furthermore, the interaction design is often completely different in the different systems, which means that the user has to switch from interaction style to interaction style, and from command structure to command structure.

One example to indicate what I mean: the notes that are made for each patient during the ward rounds are almost always written by hand at the ward where  I visited. However, after the ward round they have to be entered manually into the system, which has the double effect that it might be a slow process, taking valuable time from the nurses, and that there is also a high risk of misreading numbers and hastily jotted down notes.

The paper notes are not integrated into the computer system. While we note this, we might realize that we could need a more automated solution (which may still need proof-reading and checking). In this new solution, it would be possible for the doctor on duty to write, still by hand, on a tablet that may offer character recognition. This would reduce the tiring process of transcribing the text, making it much easier and also leave more time for other, more important tasks. 

Now, this is, in my opinion, where one of the problems with the systems in the hospital resides. We are so focused on the design of the single system, that we forget all the small details that could make the whole work situation simpler and more manageable.  Add to that that we also forget to look at the small details that should incorporate such things as:

  • specially designed portable devices, that are designed for a single task, such as taking notes for the information rounds. 
  • the development of distinct, but consistent interfaces to all the subsystems.
  • ncorporating support for the interruptions that occur during a day. Why not a “what did I do last”- kind of function? 

The conclusion of this observation is that we need to look at a work situation from a holistic and a reductionistic perspective simultaneously when we are planning and designing the digitised work place, resulting in a well planned and easily manageable rain forest of work tasks.

The Effects of Digitalization on the Nurses Work Environment DISA: The Coolest Project @ Uppsala University?

We think that we have a very cool project. We are truly a multidisciplinary team working on digitalization and the effects on the nurses work environment. We also have a very good reference group, and our collaboration with Region Uppsala in the project is fantastic.

When we saw that there was a competition about the coolest project at Uppsala University we nominated ourselves!

They will announce the winners of the competition in a couple of weeks at a faculty pub event. We´ll be there to celebrate with the winners, or perhaps we are the winners?

Start the Semester with Some Splendid Seminars

On Friday the 19th of January we have the pleasure of starting the day with two open seminars, so if you wish you can join us. From Reykjavik University we have Associate Professor Marta Lárusdóttir and from Copenhagen Business School professor Torkil Clemmensen. Torkil Clemenssen will talk about the socio-Technical Future of HCI and Marta Lárusdóttir will discuss research on the integration of UCD in industry.

The seminars will start at 10.00 in the Faculty Room at Ångström laboratory.

Marta Lárusdóttir
Integrating UCD in Agile Projects in Industry: Research Results and Future Work

Marta will give a talk on the interplay between usability activities and agile software development processes used in the IT industry. Marta has conducted research on this topic for many years collaborating with international researchers and students. Marta will give a summary of the results of these studies and describe future work on this important topic.

Marta Larusdottir is an Associate Professor at Reykjavik University with a PhD in Human-computer interaction. Marta has extensive leading knowledge in the area of evaluation and user feedback in software development. Particularly, she is a well known researcher in agile software development and how the user perspective is integrated in agile processes and has written several papers and arranged workshops on that subject.

This presentation will be followed directly by the presentation by professor Torkil Clemmensen.

Prof. Torkil Clemmensen, Copenhagen Business School
The Socio-Technical Future of HCI

Human-Computer Interaction (HCI) builds on the ideology of empowering the end-users of computers, so that they understand what is happening and can control the outcome (Nielsen, 2005). How does that work for HCI in organizations and societies? While HCI historically has been based on applying cognitive psychology to understand the individual user (Card, Moran, & Newell, 1983), one strong trend in modern and contemporary HCI is to study applications in business, managerial, organizational, and cultural contexts. To design HCI for organizations, the big thing may be to do some kind of HCI design action research that constructs or modifies one or more HCI artefacts within their existing organizational contexts: sketches, prototypes, templates, running systems – anything that changes the interactions that managers and employees do and experience. Hence, the future topics and theory of HCI may indeed be socio-technical.

Torkil Clemmensen is a professor at the Department of Digitalization, Copenhagen Business School, Denmark. His research interest is in psychology as a science of design with a focus on cultural psychological perspectives on usability, user experience, and digitalization of work. He contributes to Human-Computer Interaction, Design, and Information Systems.

Torkil Clemmensen will also lead the discussion in the afternoon when we have the half time seminar for yours truly.

“The digital development has changed the core of working life” according to professor Bengt Sandblad

Our work environment is more and more digitalized. Many of us use a large number of IT systems in our work every day. Dysfunctional computer system becomes a work environment problem.

Professor Bengt Sandblad from the HTO group has done a report for the work environment authority in Sweden, He is also working on a book and he is also working on a book on the digital work environment. The book will appear around Christmas.

This week Bengt Sandblad is interviewed in Universen and some of the key ideas in the article are:

  • The potential benefits of IT systems is often lost due to usability problems.
  • The digital development will not to slow down. On the contrary:  it will move faster and faster.
  • Often IT systems are not adapted to the needs of people, or the organization.
  • Information overload is a crucial problem.
  • We need to design systems that are made for human cognition.
  • We have a tendency to build systems based on what computers are good at. Not what people are good at.
  • There is a risk that work is what is left when the computers have done what they aren’t good at doing.

For more information read the full article 🙂