The aim of this research is to characterize the practices of asynchronous cooperation implemented by radiographers in radiotherapy in order to guarantee the quality of this treatment. This study is a part of an industrial project to design a computerized tool supporting cooperative work (workflow tool) in radiotherapy. The methodology involves observation of the entire radiotherapy process and interviews with radiographers who work in the downstream and upstream phases of the treatment. The results describe the type and function of asynchronous cooperation practices used by radiographers to manage patient variability and to organise treatment sessions in order to guarantee quality of care. They open up perspectives concerning the consideration of asynchronous cooperation practices embedded in the design of collaborative tools in healthcare field.

The aim of this research is to characterize the practices of asynchronous cooperation implemented by radiographers in radiotherapy in order to guarantee the quality of this treatment. This study is a part of an industrial project to design a computerized tool supporting cooperative work (workflow tool) in radiotherapy. The methodology involves observation of the entire radiotherapy process and interviews with radiographers who work in the downstream and upstream phases of the treatment. The results describe the type and function of asynchronous cooperation practices used by radiographers to manage patient variability and to organise treatment sessions in order to guarantee quality of care. They open up perspectives concerning the consideration of asynchronous cooperation practices embedded in the design of collaborative tools in healthcare field.

This communication deals with the involvement of ergonomists in a research-action design process of a software platform in radiotherapy. The goal of the design project is to enhance patient safety by designing a workflow software that supports cooperation between professionals producing treatment in radiotherapy. The general framework of our approach is the ergonomics management of a design process, which is based in activity analysis and grounded in participatory design. Two fields are concerned by the present action: a design environment which is a participatory design process that involves software designers, caregivers as future users and ergonomists; and a reference real work setting in radiotherapy. Observations, semi-structured interviews and participatory workshops allow the characterization of activity in radiotherapy dealing with uses of cooperative tools, sources of variability and non-ruled strategies to manage the variability of the situations. This production of knowledge about work searches to enhance the articulation between technocentric and anthropocentric approaches, and helps in clarifying design requirements. An issue of this research-action is to develop a framework to define the parameters of the workflow tool, and the conditions of its deployment.

This research is about collective production of radiotherapy care involved in cancer treatment. The aim of this research is to characterize the communicative process between actors to highlight the safety practices carried out to build, and to implement, a safe treatment. We focus here on the radiographers' activity and in particular the function of the diversity of informal exchanges between these actors who are present at the both ends of the treatment chain. Observations have been carried out to understand the work practices of each professional category. Five radiographers at simulation station and five radiographers at the treatment station were interviewed. Informal communications outlined illustrate cooperation between radiographers at the both ends of the chain. Their objective is to share specific information related to the treatment and related to the patient that may affect the treatment session. These strategies for safety production imply to manage the variability related to the patient and are achieved by anticipation between the posts promoting temporal conditions for the reproducibility and immobility of positioning the patient.

Motivation -- This research deals with the identification of collective production of a safe radiotherapy treatment and its potential assistance through computer-supported environments. It takes place at the beginning of a four years design project involving software companies and and scientific and clinical institutions. Research approach -- This work presents an exploratory analysis of cooperation between the four professionals involved in the production of radiotherapy treatment. Our general research objective is to investigate how to support managed safety in the design of a computer-supported cooperative environment. Uses and functions of cooperative tools have been outlined through observations and the "think aloud" technique. Findings/Design -- We identify three types of cooperation tools (computer-based tools, including an existing workflow, unformal verbal exchanges, and the patient body) involved in the production of a safe treatment. Their main functions are: to produce shareable data between professionals, to share the progress in the construction of a treatment and to share procedures and work practices. Research limitations/Implications -- This paper aims at contributing to the articulation of two research approaches: CSCW and safety in healthcare. Originality/Value -- Our study reveals informal strategies that participate to a "managed" healthcare safety performed by professionals. Take away message -- Our work may contribute to transform the initial technocentric approach of the design project into a more anthropocentric design project and flexible CSCW tool.

Cette etude s'inscrit dans le domaine de la radiotherapie, un des traitements contre le cancer. Le projet industriel dans lequel cette etude s'insere vise a donner une reponse technologique aux contraintes de securite dans la production du soin par le developpement d'un environnement informatique d'aide a la gestion des differentes phases du traitement, ou outil de workflow. Produire le soin radiotherapeutique en securite est le but partage par l'ensemble des operateurs impliques dans le traitement. Afin d'atteindre ce but, des outils de cooperation sont utilises par le collectif de travail en radiotherapie. L'outil de workflow fait partie de cet ensemble de supports sur lequel les differents corps de metier impliques s'appuient pour elaborer le traitement. La recherche de ce memoire porte sur l'etude exploratoire de l'usage reel des supports a la cooperation. Cette etude a pour objectif la caracterisation des fonctions du recours a ces outils et les liens avec des pratiques de securite au sein du collectif. Pour repondre a ces objectifs, trois etudes empiriques sont mises en place dans un grand centre parisien de recherche et de traitement contre le cancer. Dans un premier temps, des observations ouvertes et systematiques permettent la realisation d'un etat des lieux des outils de cooperation utilises par le collectif dans la construction du traitement. Dans un deuxieme temps, la technique des protocoles verbaux en situation d'utilisation d'un outil d'affichage collectif du workflow, met en evidence son utilisation reelle dans le plateau technique. Enfin, sur la base des entretiens semi-directifs, nous essayerons de comprendre la cooperation entre les postes en bout de chaine car elle n'est pas consideree par l'outil de workflow prescrit en place. Les resultats de ces trois etudes montrent la diversite des outils a la cooperation au sein du collectif, les differences quant au recours de ces supports en fonction des corps de metiers et les cooperations autour du patient, mises en place en bout de chaine. A partir de ces resultats, on peut conclure que l'importance de l'actualisation collective de la conscience de la situation a partir de la mobilisation des supports et la mise en place des strategies de cooperation en vue de pallier les carences dans l'utilisation prescrite des outils de cooperation, sont a la base de l'anticipation des situations dysfonctionnelles pour le reste des membres du collectif, favorisant ainsi la securite dans la construction collective du soin.