Entangled in complexity: An ethnographic study of organizational adaptability and safe care transitions for patients with complex care needs.

Aim: The aim of this study was to visualize vulnerabilities and explore the dynamics of inter-professional collaboration and organizational adaptability in the context of care transitions for patients with complex care needs.

Design: An ethnographic design using multiple convergent data collection techniques.

Methods: Data collection involved document review, participant observations and interviews with healthcare and social care professionals (HSCPs).

Exploring interdependencies, vulnerabilities, gaps and bridges in care transitions of patients with complex care needs using the Functional Resonance Analysis Method.

Background: Hospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- and inter-organisational everyday work needs to be properly understood, including its interdependencies, vulnerabilities and gaps. The aims of this study were to 1) map coordination and team collaboration across healthcare and social care organisations, 2) describe interdependencies and system variability in the discharge process for older people with complex care needs, and 3) evaluate the alignment between discharge planning and the needs in the home.

Exploring patient flow management through a lens of cognitive systems engineering.

Hospitals work to provide quality, safety, and availability to patients with a wide variety of care needs, which makes efficient prioritisation and resource utilisation essential. Anticipation of each patients' trajectory, while monitoring available resources across the hospital, are major challenges for patient flow management. This study focuses on how hospital patient flow management is realised in situ with the help of concepts from cognitive systems engineering.

Communicating intended routes in ECDIS: evaluating technological change.

Misunderstanding each other's intentions is one of the most common causes of shipping accidents. By sending out a number of waypoints ahead and displaying them on the Electronic Chart Display and Information System (ECDIS) a ship's intentions would be clearly visible for other ships. Displaying ships' intentions would be a major change compared to navigation today.

Decision support for vessel traffic service (VTS): user needs for dynamic risk management in the VTS.

Vessel Traffic Service (VTS) is a shore-side service implemented by a "Competent Authority to improve the safety and efficiency of vessel traffic and to protect the environment". It is a service that operates through VTS centers, from which VTS operators monitor traffic, assist in navigational matters and provide information to all ships in a designated area. As VTS is provided by operators located on shore, they usually make use of several decision support systems to be able to monitor the traffic and to provide information to the vessels.