1,647 research outputs found

    Can the NHS learn about human factors from the Ministry of Defence?

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    The National Health Service (NHS) in England has ambitious plans to drive innovation in health information technology (HIT) to improve patient safety, quality and cost effectiveness. Acute trusts are complex socio-technical systems that are required to implement a number of large information technology projects in order to meet national targets for digital maturity. This research explored whether the Ministry of Defence (MOD) Human Factors Integration Model for the acquisition process could be applied to a HIT project. A qualitative research study was undertaken in a large English NHS acute trust using the experience of implementing an electronic observation system to explore transferability of the MOD approach to acute healthcare. Data were collected using semi-structured interviews and focus groups and analysed thematically with reference to SEIPS 2.0 (Holden et al, 2013) healthcare systems model and the MOD framework. Key findings included limited awareness of Human Factors in healthcare; information system design/specification to deliver positive outcomes around patient safety and financial savings. Human Factors negative systems issues included alert fatigue, changing mental models, inability to maximise data for patient benefit, system resilience, local and national interoperability issues

    Exploring the Implementation Process of Technology Adoption In Long-term care Nursing Facilities.

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    There is little understanding of how long-term care settings implement and adopt technology. The study purpose was to set forth a model that integrates implementation science and technology adoption frameworks and to explore the process of EHR technology implementation leading to adoption. Research questions investigated key stakeholders’ experiences with the implementation, if adoption occurred, and what themes mapped to the new model. There were three components of the dissertation. Based on a critical analysis of the literature, a model was set forth that integrates implementation science and technology adoption frameworks. Next, the experiences of 30 key stakeholders in three nursing homes were explored to understand implementation strategies. The third was one in-depth case study to explore EHR implementation and adoption. The first study was an exploratory qualitative study using grounded theory methods with focus groups (nurses and certified nurse aides) and individual interviews (Directors of Nursing) conducted at three Midwestern nursing homes with various numbers of beds (99-200), locations, and stages of implementation. A stratified random sample was used for focus groups (nurses and certified nurse aides). Data analysis included constant comparison of data. The second study an in-depth case study at a 124 bed, inner-city nursing home. Data sources were interviews of nurses and nurse aides (15), observation sessions of key care events (15), and leadership meetings. Data analysis included using constant comparison of themes and descriptive statistics (activity frequencies and percentages). Integration of data occurred to illustrate the dynamics of implementing and adopting the EHR. Five major themes emerged which included: motivation and EHR adoption, factors that influence the implementation, audit and bi-directional feedback, benefits, and opportunities to improve the EHR. The studies supported the new model with the workflow concept broadened to work processes. The importance of this dissertation is that it added to the knowledge of individual’s and system’s perspectives about implementation and adoption of an EHR in LTC facilities. The study supported the new Integrated Technology Implementation model concepts. Future research that is designed prospectively using this new model is needed. Other types of users should be studied such as administrators, physicians, and residents.PhDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/113622/1/rhondas_1.pd

    Human factors considerations in designing for infection prevention and control in neonatal care – findings from a pre-design inquiry

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    Qualitative data collection methods drawn from the early stages of human-centred design frameworks combined with thematic analysis were used to develop an understanding of infection prevention practice within an existing neonatal intensive care unit. Findings were used to generate a framework of understanding which in turn helped inform a baseline approach for future research and design development. The study revealed that a lack of clarity between infection transmission zones and a lack of design attributes needed to uphold infection prevention measures may be undermining healthcare workers’ understanding and application of good practice. The issue may be further complicated by well-intentioned behavioural attitudes to meeting work objectives; undue influences from spatial constraints; the influence of inadvertent and excessive touch-based interactions; physical and/or cognitive exertion to maintain transmission barriers; and the impact of expanding job design and increased workload to supplement for lack of effective barriers

    Lessons Learned: Solutions for Workplace Safety and Health

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    Provides case studies of workplace health hazards, regulatory actions taken, and solutions, including product and design alternatives; a synthesis of findings and lessons learned; and federal- and state-level recommendations

    State of Science: ergonomics and global issues

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    In his 1993 IEA keynote address, Neville Moray urged the ergonomics discipline to face up to the global problems facing humanity and consider how ergonomics might help find some of the solutions. In this State of Science article we critically evaluate what the ergonomics discipline has achieved in the last two and a half decades to help create a secure future for humanity. Moray’s challenges for ergonomics included deriving a value structure that moves us beyond a Westernised view of worker-organisation-technology fit, taking a multidisciplinary approach which engages with other social and biological sciences, considering the gross cross-cultural factors that determine how different societies function, paying more attention to mindful consumption, and embracing the complexity of our interconnected world. This article takes a socio-historical approach by considering the factors that influence what has been achieved since Moray’s keynote address. We conclude with our own set of predictions for the future and priorities for addressing the challenges that we are likely to face. Practitioner Summary: We critically reflect on what has been achieved by the ergonomics profession in addressing the global challenges raised by Moray's 1993 keynote address to the International Ergonomics Association. Apart from healthcare, the response has largely been weak and disorganised. We make suggestions for priority research and practice that is required to facilitate a sustainable future for humanity

    Exploring the impact of telehealth videoconferencing services on work systems for key stakeholders in New Zealand : a sociotechnical systems approach : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Management at Massey University, Albany, New Zealand

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    Figure 2.9 is re-used under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. Figures 2.11 and 2.13 are re-used with the publishers' permission.This thesis explores how the impacts of telehealth videoconferencing services (THVCS) on work systems are perceived by key stakeholders in New Zealand. Telehealth - the use of information and communications technologies to deliver healthcare when patients and providers are not in the same physical location - exemplifies how technological developments are changing the ways in which healthcare is provided and experienced. With the objectives of improving access, quality, and efficiencies of financial and human resources, THVCS use real time videoconferencing to provide healthcare services to replace travel to a common location. Despite the benefits of telehealth reported in the extant literature, there continues to be difficulties with developing and sustaining services. The aim of this inquiry is to understand how THVCS impact key stakeholders in the work system. Specifically, it seeks to examine the characteristics of THVCS in the New Zealand context, identify the facilitators and barriers to THVCS, and understand how the work system can adapt for THVCS to be sustained practice. The research design is framed by a post-positivist approach and underpinned by sociotechnical systems (STS) theory. STS theory and a human factors/ergonomics design approach inform the methodology, including the use of the SEIPS 2.0 model. Forty semi-structured qualitative interviews and contextual observations in a two-phase methodology explore the perceptions of an expert telehealth group, and providers, receivers, and decliners of THVCS. These data are analysed using the framework method of thematic analysis. The key findings suggest that to enable sustained THVCS in New Zealand, factors such as new ways of working; change; human connection; what is best for patient; and equity need to be recognised and managed in a way that balances costs and consequence and ensures fit across the work system. Theoretical contributions to knowledge are made through the development of a conceptual model from the literature, exploring THVCS with an STS theory lens and developing SEIPS 2.0. Methodologically, this inquiry contributes a theory-based, qualitative approach to THVCS research and draws on the perceptions of unique groups of participants. Significantly, the findings make practical contributions to the design of the THVCS in the New Zealand context

    “Rooming the Patient” vs. “Moving the Patient

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    Healthcare is coming under ever increasing scrutiny for cost, quality, safety, and patient satisfaction. This paper compares two operational models (“rooming the patience” vs. “moving the patient”) against productivity, privacy, user satisfaction, and other performance measurements. Varying risk factors for patient populations ranging from infants to geriatrics and medical specialties from mental health to orthopedics are addressed for both models. In the first operational model after checking-in the patient is escorted to an examination room and waits as various caregivers (nurses, doctors, clerks, etc.) come and go from the exam room. In the second model the caregivers work from a specific location and the patient moves between the waiting room and these caregiver\u27s locations (reception desk, office/exam room, scheduling desk, etc.) and back to the waiting room multiple times. The paper concludes that there are advantages and disadvantages for each model. The best model depends on both the patient type and care being provided. In some situation there are conflicting results depending on the priority of productivity vs. service level. Regardless of the situation, human factors should be an important consideration in any healthcare decision

    Holistic outcome-based visualisations for defining the purpose of healthcare system

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    Various stakeholders in the complex healthcare systems often prioritise and pursue different purposes, values and outcomes. Understanding/sharing/negotiating the trade-offs between them is a critical action in the development and design of complex healthcare systems. Some approaches like work domain analysis or soft systems methodology attempted to map the complex interactions, but it remains unclear how those maps and visualisations are in line with how people conceptualise in practice. This study aims to explore how designers visualise complex system interactions using healthcare outcomes to define the purpose. A workshop was conducted with 23 designers to generate outcome-based visualisations. The results indicate that designers conceptualise the purpose of the healthcare systems in different ways. Complexity was expressed through organic circles and messy arrows. However, support elements are needed to conduct open visualisations. These results may play a role in developing a visualisation-based method to address the complexity of purpose definition in healthcare
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