Hybrid cognition in medical discharges

Abstract

PurposeThe purpose of this study is to gain insight into the interaction-sensitive skills medical practitioners enact as they manage multiple organizational factors in the context of discharging patients.Design/methodology/approachFor that purpose, we carried out a cognitive ethnographic study in a Danish hospital, where we video-recorded three pre-ward round meetings, five discharge conversations and conducted seven semi-structured interviews. Fieldnotes and interview transcripts were analyzed using the method Cognitive Task Analysis, and video-recordings were analyzed via the interactivity-based approach Cognitive Event Analysis.FindingsOur findings show that practitioners coordinate multi-scalar resources (e.g. verbal patterns and cognitive artifacts) in order to discharge patients in a safe and integrated way, which we propose amounts to the social and intercorporeal ability to align simultaneously emerging factors, like organizational procedures in the hospital, artifacts in use, sociocultural resources and the individual medical expertise of the practitioner in the emerging social interaction with the patient. In pursing this claim, we investigate the linguistic and cognitive processes emerging in a single case study of a nurse who discharges a patient. We propose that the interaction-sensitive skill which enables the nurse to solve the task of discharging the patient can be characterized via hybrid cognition.Originality/valueThus, the value of the article is dual: On the one hand, it empirically contributes with knowledge of the complex organizational structures that constrains micro-level medical interactions in discharges, and on the other, the article contributes theoretically with a hybrid cognitive framework that allows organizational researchers to understand and assess complex cognitive and linguistic processes that goes into the social micro-coordination in complex organizational-medical task.