Fixation and Attention Allocation in Anesthesiology Crisis Management: an Abstraction Hierarchy Perspective

The abstraction hierarchy analysis tool developed by Vicente and Rasmussen (1992) for Ecological Interface Design (EID) provides an in depth understanding of work domain constraints and information requirements. EID and work domain analysis (WDA) have been successfully applied in several fields. However, application in the medical domain has proven to be much more difficult. This study examines the relationships between three components within the OR: the surgical team, medical equipment, and the patient. It is hypothesized that crisis management failure in the OR is due to attentional mis-allocation and can be undone by re-directing team members' attention to the appropriate level of information structure. We propose a novel structure, based on existing work domain models for the operating room, to analyze the behavior of OR teams and map their attention allocation within the abstraction hierarchy to explain fixation during medical problem solving and crisis management.