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  • 1.
    Boström, Magnus
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Breaking the ice: a work domain analysis of icebreaker operations2018In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 20, no 3, p. 443-456Article in journal (Refereed)
    Abstract [en]

    Icebreakers are special-purpose ships designed to operate in different ice-covered waters, either independently or duringassistance of weaker ships. In the Baltic Sea, as well as elsewhere, they are essential for maintaining continuous sea transportservices during wintertime. Icebreaker operations are complex, and every situation in which a vessel requires assistanceis unique, due to, e.g. changing ice and weather conditions, geographical location or language proficiency of the crew onboard the icebreaker or assisted vessel. The icebreaker crew has considerable freedom to adapt to each situation, yet, forsafe operations, there are constraints to which the crew has to conform. The study presented in this paper aims at identifyingthe constraints on nautical officers on board icebreakers during operations, as well as special situations that increasecognitive load. A work domain analysis based on a group interview with nautical icebreaker officers shows the multitudeof tasks performed on board icebreakers. Furthermore, it identifies constraints specific to icebreaker operations such as iceassessment and direct icebreaking, but also generic constraints such as language and communication skills. At times, safetyand efficiency come into conflict, resulting in a trade-off between the two. When that happens, safety gets priority, and theoperation stops until the situation has been evaluated. In addition, several situations that increase cognitive load are identified,with the common denominator that they add elements of uncertainty, e.g. severe weather and technical malfunctions.Finally, further research within the area of icebreaker operations is recommended, with a continued focus on the systemconstraints, and their potential for system improvement.

  • 2.
    Ekstedt, Mirjam
    et al.
    KTH Royal Institute of Technology.
    Ödegård, Synnöve
    KTH Royal Institute of Technology.
    Exploring Gaps in Cancer Care Using a Systems Safety Perspective2015In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 17, no 1, p. 5-13Article in journal (Refereed)
    Abstract [en]

    Gaps in the continuity of care may appear as losses of information or momentum or as interruptions in the delivery of care. To systematically improve patient safety, we need to know more about how gaps in the continuity of health care are identified and mitigated. This study seeks to describe healthcare professionals’ understanding of how they anticipate, detect and handle gaps in cancer care. Ten focus-group interviews and two individual interviews were conducted with a total of 34 cancer-care professionals (physicians, nurses, managers and administrators)from three counties in mid-Sweden. Various specialties in cancer care were covered: primary care, inhospital care, palliative care, advanced home are, and children’s care. Interviews were analyzed inductively using qualitative content analysis. The results show that patient safety in cancer care is dependent on a resilient organization that is capable of anticipation, monitoring, adapting and learning at all levels of care. The professionals anticipated gaps in situations where contacts between healthcare providers were limited and when they were faced by time or resource constraints. The extent to which aps could be managed by professionals at the sharp end was largely determined by their bility to adapt to complex and unexpected situations in their daily work. The management of gaps was perceived differently by managers and clinicians, however. The study also indicates hat the continuity of care could be improved by patients’ participation in decisions about reatments and care plans, and by a mutual responsibility for the transfer of information and knowledge across professional boundaries. These results are discussed from a resilience ngineering perspective, and they emphasize the management’s responsibility to address gaps identified in the system. Designing resilient healthcare organizations enables professionals at  the sharp end to prevent human error or mitigate its consequences.

  • 3.
    van Westrenen, Fulko
    et al.
    Umantec, The Netherlands.
    Praetorius, Gesa
    Chalmers University of Technology.
    Maritime traffic management: a need for central coordination?2014In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 16, no 1, p. 59-70Article in journal (Refereed)
    Abstract [en]

    Traffic management is not formally organised in the maritime domain. Ships are autonomous and find their own way. Traffic is organised through rules, regulations, and “good seamanship”; it is a distributed system. In areas of high traffic-density support is proved by vessel traffic service (VTS) to promote traffic safety and fluency. VTS does not take control. This organisational structure has proven itself in situations with sufficient resources. When resources become insufficient (e.g. not enough sailing space), the traffic needs an organising mechanism. In this article, the authors argue that the most promising way to do this is by organising centralised planning coordination, whilst leaving maritime traffic a distributed system with no additional central control.

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