Repetita iuvant: exploring and supporting redundancy in hospital practices

This paper discusses the role of redundancy in hospital work, especially in facilitating the cognitive and coordinative tasks of health practitioners in clinical settings. It also investigates the ways in which health information technology can preserve, support and even enhance this role by being grounded in the observations and analyses that two research groups in Italy and Norway carried out in independent studies. In the present study, this previous research is reassessed and shaped into a unified and coherent design-oriented framework. This framework considers four kinds of data redundancy and outlines their peculiarities and the typical conditions in which they occur. In particular, the paper reports how these kinds of redundancies are exploited in both written artifacts and oral communications and how they affect each other. The paper also reports the impact of redundancies on the articulation work of physicians and nurses by playing either a negative or, more often, a positive role depending on the context. A series of lessons learnt are then proposed for the design of suitable coordination mechanisms that could preserve or even utilize this neglected phenomenon, which is strongly related to the interpretative and coordinative practices that are articulated in the patient's record.