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An interview analysis of coordination behaviours in out-of-hours secondary care

Martindale, Sarah; Golightly, David; Pinchin, James; Shaw, Dominick; Blakey, John; Perez, Iker; Sharples, Sarah


Sarah Martindale

David Golightly

James Pinchin

Dominick Shaw

John Blakey

Iker Perez

Sarah Sharples


This paper seeks to elicit and structure the factors that shape the execution and, in particular, the coordination of work in Out of Hours care. Evenings and weekends in UK hospitals are managed by specific Out of Hours (OoH) care arrangements, and associated technology. Managing care within the constraints of staff availability and demands is a key concern for both patient care and staff wellbeing, yet has received little attention from healthcare human factors. A study of sixteen clinical staff used Critical Decision Method to understand how work is coordinated and the constraints and criteria that are applied by the roles managing OoH care. The analysis identified ten types of coordination decision which, in turn, underpinned three types of adaptive behaviour-pre-emption, information augmentation and self-organisation-that were crucial for the effective performance in OoH care. These behaviours explain how OoH staff manage the task demands placed on them, individually and as a team.

Journal Article Type Article
Publication Date Jun 22, 2019
Print ISSN 0003-6870
Electronic ISSN 1872-9126
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 81
Article Number 102861
APA6 Citation Martindale, S., Golightly, D., Pinchin, J., Shaw, D., Blakey, J., Perez, I., & Sharples, S. (2019). An interview analysis of coordination behaviours in out-of-hours secondary care. Applied Ergonomics, 81, doi:10.1016/j.apergo.2019.05.011
Keywords Out of Hours care; healthcare; coordination; complex systems; workload management 2
Publisher URL


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