Evidence map›Paper›PMID 40843491›Full record

ArticleErgonomics2026

Coordination patterns as markers of brittleness (and resilience) in complex systems: a sterile processing case study.

Jacob Hionis, Sudeep Hegde, Gabriel Segarra, Steven Foster, E Miriam Balkin, Michael F Rayo, Lawrence Fredendall, Kevin Taaffe, Ken Catchpole

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Ergonomics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jacob HionisClemson University, Clemson, SC, USA.
Sudeep HegdeClemson University, Clemson, SC, USA.ORCID 0000-0001-9711-8459
Gabriel SegarraMedical University of South Carolina, Charleston, SC, USA.
Steven FosterClemson University, Clemson, SC, USA.
E Miriam BalkinThe Ohio State University, Columbus, OH, USA.
Michael F RayoThe Ohio State University, Columbus, OH, USA.ORCID 0000-0003-0180-058X
Lawrence FredendallClemson University, Clemson, SC, USA.
Kevin TaaffeClemson University, Clemson, SC, USA.
Ken CatchpoleMedical University of South Carolina, Charleston, SC, USA.

Funding

AHRQ HHS R01 HS027912
6 · The paper itself

Abstract

Coordination underpins adaptive capacity in resilient systems. However, research on specific patterns of coordination as they relate to adaptive capacity is relatively scarce. The study focuses on the Sterile Processing Department (SPD) as an exemplar of a large complex system with significant coordination challenges. The study aimed to identify adaptive performance under countervailing pressures, and coordination patterns that enable adaptive capacity. Six observations and eighteen interviews of OR and SPD workers were conducted. Data were analyzed for themes and inherent semantic relationships. Schematic diagrams were developed to compactly represent the adaptive workflow patterns along with the associated interactions supporting coordination. Coordination patterns, such as concatenated loops, were identified as markers of system brittleness. Implications for supporting coordination and adaptive capacity under complexity are provided.

Indexed as

WorkflowHumansOrganizational Case StudiesAdaptive performancecomplex systemscoordinationhealthcare

Identifiers

PMID40843491
PMCPMC13157718

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.