Clinical Processes in an Innovative Vascular Surgeon Community. Implications for Workflow Modeling

OBJECTIVE To identify factors influencing variations in clinical work in the care of patients with abdominal aortic aneurism. METHOD Ethnographic observations of 26 meetings between surgeons and patients in two community hospitals and one university hospital. Observations data were abstracted into scenarios that describe the typical clinical workflow. Characterizations of features of the scenarios were performed. RESULTS When comparing the university hospital and the community hospitals we find large variations in patient trajectories, and in the relation between actors' and roles. CONCLUSION Given a clinical domain distinguished by an unrelenting search for new and improved surgical techniques, workflow system requirements should reflect that healthcare planning not only is conducted with the purpose of providing care but also with purpose of developing new or maintaining existing surgical skills.