ABSTRACT Workarounds in high‐hazard environments like intensive care units (ICUs) compromise safety and regulatory compliance. While prior research attributes these deviations to technology misfits and notes self‐reinforcing dynamics, the underlying mechanisms of aggravating workaround spirals remain understudied. Drawing on ethnographic observation and interviews investigating Critical Care Information System (CCIS) use, we advance a mental resource perspective positioning clinicians' cognitive load as a key driver of aggravating workarounds. Grounded in Conservation of Resources (COR) Theory and organisational control literature, we demonstrate that clinicians use workarounds (i.e., deviating CCIS use) to cope with mental overload. However, workarounds bypass not only workflow obstacles, but also organisational controls intended to support individual and collective attention. As these ‘constructive IS attention controls’ collapse, clinicians' mental load intensifies and cooperative workflows deteriorate, spawning additional workarounds in a recursive cycle linking individual coping to collective resource depletion. Our study contributes theoretically by (1) identifying mental resource depletion as one mechanism aggravating workarounds, (2) specifying this mechanism through compromised attention management, and (3) developing a process model that integrates behavioural psychology with control theory to capture how individual resource deficits and coping scale to organisational level risks. For practice, we demonstrate that addressing isolated technology misfits is insufficient to mitigate workarounds in high‐acuity settings. Instead, systemic interventions are required, such as rebalancing workload, reinforcing resilient attention controls and designing CCIS that support (re‐)focusing individual and collective attention. These insights orient scholarship and management toward cognitively sustainable healthcare technologies.
Kuss et al. (Tue,) studied this question.