Breakdowns in collaborative information seeking: A study of the medication process

Collaborative information seeking is integral to many professional activities In hospital work, the medication process encompasses continual seeking for information and collaborative grounding of information. This study investigates breakdowns in collaborative information seeking through analyses of the use of the electronic medication record adopted in a Danish healthcare region and of the reports of 5 years of medication incidents at Danish hospitals. The results show that breakdowns in collaborative information seeking is a major source of medication incidents, that most of these breakdowns are breakdowns in collaborative grounding rather than information seeking, that the medication incidents mainly concern breakdowns in the use of records as opposed to oral communication, that the breakdowns span multiple degrees of separation between clinicians, and that the electronic medication record has introduced risks of new kinds of breakdown in collaborative information seeking. In working to prevent and recover from breakdowns in the seeking and sharing of information a focus on collaborative information seeking will point toward collaborative, organizational, and systemic reasons for breakdown and areas for improvement, rather than toward individual error. (C) 2009 Elsevier Ltd All rights reserved