title: Clinical processes in an innovative vascular surgeon community. Implications for workflow modeling.
abstract: OBJECTIVE
  To identify factors influencing variations in clinical work in the care of patients with abdominal aortic aneurism.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Norwegian EHR Research Centre (NSEP), Medical technical research Centre, Trondheim, Norway. Berit.J.Brattheim@ntnu.no
authors.forename: Berit
authors.initials: B
authors.lastname: Brattheim
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Seim
authors.forename: Arild
authors.initials: A
authors.lastname: Faxvaag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003198:Computer Simulation; D020000:Decision Support Systems, Clinical; D017598:Efficiency, Organizational; D005260:Female; D019983:Guideline Adherence; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D015607:Stents