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Background It is uncertain whether lung-protective mechanical ventilation using low tidal volumes should be used in all critically ill patients, irrespective of the presence of the acute respiratory distress syndrome (ARDS). A low tidal volume strategy includes use of higher respiratory rates, which could be associated with increased sedation needs, a higher incidence of delirium, and an increased risk of patient-ventilator asynchrony and ICU-acquired weakness. Another alleged side-effect of low tidal volume ventilation is the risk of atelectasis. All of these could offset the beneficial effects of low tidal volume ventilation as found in patients with ARDS. Methods/Design PReVENT is a national multicenter randomized controlled trial in invasively ventilated ICU patients without ARDS with an anticipated duration of ventilation of longer than 24 hours in 5 ICUs in The Netherlands. Consecutive patients are randomly assigned to a low tidal volume strategy using tidal volumes from 4 to 6 ml/kg predicted body weight (PBW) or a high tidal volume ventilation strategy using tidal volumes from 8 to 10 ml/kg PBW. The primary endpoint is the number of ventilator-free days and alive at day 28. Secondary endpoints include ICU and hospital length of stay (LOS), ICU and hospital mortality, the incidence of pulmonary complications, including ARDS, pneumonia, atelectasis, and pneumothorax, the cumulative use and duration of sedatives and neuromuscular blocking agents, incidence of ICU delirium, and the need for decreasing of instrumental dead space. Discussion PReVENT is the first randomized controlled trial comparing a low tidal volume strategy with a high tidal volume strategy, in patients without ARDS at onset of ventilation, that recruits a sufficient number of patients to test the hypothesis that a low tidal volume strategy benefits patients without ARDS with regard to a clinically relevant endpoint. Trial registration The trial is registered at www.clinicaltrials.gov under reference number NCT02153294 on 23 May 2014.

Collaboration engineering is an approach for the design and deployment of repeatable collaboration processes that can be executed by practitioners without the support of collaboration professionals such as facilitators. A critical challenge in collaboration engineering concerns how the design activities have to be executed and which design choices have to be made to create a process design. We report on a four-year design science study in which we developed a design approach for collaboration engineering that incorporates existing process design methods, pattern-based design principles, and insights from expert facilitators regarding design challenges and choices. The resulting approach was evaluated and continuously improved in four trials with 37 students. Our findings suggest that this approach is useful to support the design of repeatable collaboration processes. Our study further serves as an example of how a design approach can be developed and improved following a multimethod design science approach.

The potential benefits of collaboration technologies are typically realized only in groups led by collaboration experts. This raises the facilitator-in-the-box challenge: Can collaboration expertise be packaged with collaboration technology in a form that nonexperts can reuse with no training on either tools or techniques? We address that challenge with process support applications (PSAs). We describe a collaboration support system (CSS) that combines a computer-assisted collaboration engineering platform for creating PSAs with a process support system runtime platform for executing PSAs. We show that the CSS meets its design goals: (1) to reduce development cycles for collaboration systems, (2) to allow nonprogrammers to design and develop PSAs, and (3) to package enough expertise in the tools that nonexperts could execute a well-designed collaborative work process without training.

Research shows that under certain conditions, groups using collaboration technologies such as group support systems (GSS) can gain substantial improvements in the effectiveness and efficiency of their work processes. GSS, however, have been slow to develop self-sustaining communities of users in the workplace. Organizations that use collaboration technology may require two kinds of support: process support and technology support. Both types of support involve (1) design tasks (e.g., designing a work process and designing the technology to support the process), (2) application tasks (to apply the process and to use the technology), and (3) management tasks (to monitor and control the process and to oversee the maintenance of the technology). This paper explores how these tasks and associated roles can be anchored in organizations, and the relationship of task allocation patterns to the sustained use of collaboration technology in organizations.

This paper presents a training approach to support the deployment of collaboration process support according to the Collaboration Engineering approach. In Collaboration Engineering, practitioners in an organization are trained to facilitate a specific collaborative work practice on a recurring basis. To transfer the complex skill set of a facilitator to support the practitioner in guiding a specific collaboration process design, we propose a detailed training approach based on the logic of Cognitive Load Theory. The training approach focuses on transferring knowledge and skills in the form of thinkLets, i.e. repeatable facilitation techniques. Furthermore, the training contains a process simulation to practice challenges in collaboration support. The training approach was positively evaluated using a questionnaire instrument in a case study.

Groups often rely on the expertise of facilitators to support them in their collaboration processes. The design and preparation of a collaboration process is an important facilitation task. Although there is a significant body of knowledge about the effects of facilitation, there is a dearth of knowledge about the ways in which facilitators design collaboration processes. Increased understanding in this area will contribute to the effective design and use of collaboration support and to the development of collaboration process design support. The research reported in this paper explores the strategies and techniques facilitators use to design a collaboration process, and the aspects of this task they perceive as challenging. We present the results of a questionnaire among professional facilitators. We compare facilitators with different expertise levels to identify challenges in the design of collaboration processes. We discovered that although the activities performed and information used by novices is not very different from expert practices, their limited experience makes them less flexible. When the actual session brings surprises such as different outcomes or conflict, novices cannot easily adapt their designs to accommodate these. [PUBLICATION ABSTRACT]

Collaboration Engineering is an approach to create sustained collaboration support by designing collaborative work practices for high-value recurring tasks, and transferring those designs to practitioners to execute for themselves without ongoing support from collaboration professionals. A key assumption in this approach is that we can predictably design collaboration processes. In this paper we explore this assumption to understand whether collaboration can, in fact, be designed, and elaborate on the role of thinkLets in the engineering of collaborative work practices. ThinkLets are design patterns for collaborative interactions.

Collaboration Engineering (CE) is an approach to design and implement sustained collaboration support for collaborative work practices. A collaboration engineer designs a collaboration process and trains a practitioner to execute it on a recurring basis, without further support from professional facilitators. The CE design should be predictable and transferable for successful reuse by the practitioner. The documentation requirements for a CE design are addressed so it can be effectively transferred to practitioners. This documentation or script should contain precise instructions and interventions that the practitioner should make to guide the group in achieving their goals. To detail the requirements for this design document, the authors analyzed the tasks of a facilitator as a basis to derive the tasks of a practitioner. Cognitive Load Theory was used to derive documentation requirements with respect to the CE process design. The authors validated these requirements in an expert validation session and through two case studies.

This paper addresses the variance in findings across Group Support Systems (GSS) studies by suggesting an expanded consideration of organizational and contextual elements in Adaptive Structuration Theory (AST). We propose a model of structuring tactics at three levels of abstraction: the meeting level, activity level, and real time intervention level. We illustrate this model with three specific purposeful structuring tactics - agendas, design patterns, and micro-processes -and present related propositions. In addition to reviewing the more familiar tactics of agenda setting and group facilitation, we illustrate an approach to creating GSS value based on invoking particular social structures. We accomplish this through consideration of a design pattern language for collaboration processes drawn from the Collaboration Engineering literature. We conclude by discussing how this model of structuring tactics advances theory and practice in the GSS domain. [PUBLICATION ABSTRACT]