This paper examines how heterogeneous technologies impact the coordination of knowledge work in complex socio-technical settings. It is based on an in-depth field study of critical care practices characterized by intensive knowledge work and technological heterogeneity. We observe that heterogeneous technologies create workflow gaps within which health professionals adapt technology use to contingencies and local needs, prioritize interventions, and identify problems before they become detrimental to patient care. These adaptations provide opportunities for health professionals to continuously align work across heterogeneous technologies and to accomplish broader professional and ideological goals. Our analysis shows that health professionals use three coordination practices when working across heterogeneous technologies: controlling and enhancing information, reconstructing workflows, and circumventing requirements. We theorize how these practices address coordination needs associated with heterogeneous technologies and discuss implications for knowledge work. We provide a more complete understanding of coordination practices in complex, socio-technical settings which contributes to both knowledge work and coordination literatures.

本文研究了异构技术如何影响复杂社会技术环境中知识工作的协调。它基于对以密集知识工作和技术异质性为特征的重症监护实践进行的深入实地研究。我们观察到异构技术造成了工作流程差距，在这些差距中，卫生专业人员根据突发事件和当地需求调整技术使用，优先干预，并在问题对患者护理有害之前发现问题。这些调整为卫生专业人员提供了机会，使他们能够不断调整跨异构技术的工作，并实现更广泛的专业和意识形态目标。我们的分析表明，卫生专业人员在跨异构技术工作时使用三种协调做法：控制和增强信息、重构工作流程和规避需求。我们对这些实践如何解决与异构技术相关的协调需求进行理论化，并讨论对知识工作的影响。我们对复杂的社会技术环境中的协调实践提供了更完整的理解，这有助于知识工作和协调文献。