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Coordination of perioperative work is challenging. Advancements in diagnostic and therapeutic possibilities have not been followed by similar advancements in the ability to coordinate care. In this paper, we report on a study that explored the nature of continuous coordination as practiced by perioperative staff in order to coordinate their own activities with respect to those of their colleagues. We conducted in-depth interviews ( n = 14), and combined observations and focused interviews ( n = 31) with perioperative staff (physicians, nurses, technicians, and cleaners) at a major university hospital in Norway. Data were analysed qualitatively with systematic text condensation. The results indicated that a surgical schedule was important for informing staff members about the cases and tasks they had been assigned. Staff also depended on ad hoc, explicit communication to ensure timeliness of particular perioperative activities. This, however, left little room for adjustments of other activities. Hence, to be able to proactively coordinate their own work some staff tried to predict future perioperative activities by observing the workplace, monitoring the surgical scheduling software for changes, and sharing their colleagues' progress updates and predictions. These findings could be important for those developing support for perioperative coordination. [ABSTRACT FROM AUTHOR]

Background: Trauma teams improve the initial management of trauma patients. Optimal timing of trauma alerts could improve team preparedness and performance while also limiting adverse ripple effects throughout the hospital. The purpose of this study was to evaluate how timing of trauma team activation and notification affects initial in-hospital management of trauma patients. Methods: Data from a single hospital trauma care quality registry were matched with data from a trauma team alert log. The time from patient arrival to chest X-ray, and the emergency department length of stay were compared with the timing of trauma team activations and whether or not trauma team members received a preactivation notification. Results: In 2009, the trauma team was activated 352 times; 269 times met the inclusion criteria. There were statistically significant differences in time to chest X-ray for differently timed trauma team activations (P = 0.003). Median time to chest X-ray for teams activated 15-20 minutes prearrival was 5 minutes, and 8 minutes for teams activated <5 minutes before patient arrival. Timing had no effect on length of stay in the emergency department (P = 0.694). We found no effect of preactivation notification on time to chest X-ray (P = 0.474) or length of stay (P = 0.684). Conclusion: Proactive trauma team activation improved the initial management of trauma patients. Trauma teams should be activated prior to patient arrival. [ABSTRACT FROM AUTHOR]