Crossing the macro-micro divide in systems ergonomics

This paper attempts to further explore the concept of mesoergonomics and the implications this has for the use of the systems approach within ergonomics. The concept has been applied within the field of organisational behaviour to understand a wide variety of complex work contexts and the interaction between individual, group and organisational levels of analysis. More recently, researchers in human factors and ergonomics have similarly argued that there is a need for holistic, integrated accounts of the relationship between macro- and micro- system levels (Karsh, 2003). In order to go some way toward achieving this, we outline two case studies drawn from health care (infection control, electronic medical records) and analyze these using mesoergonomic constructs. The case studies are used to outline a set of steps towards a more general framework for mesoergonomic research

Quality of Work Life of Independent vs Employed Family Physicians in Wisconsin: A WReN Study

PURPOSE Family physicians in Wisconsin who are mainly employed by large health care organizations have voiced concerns regarding the quality of their work lives. We explored the quality of work life and its relationship to employment by health care organizations. METHODS We conducted a cross-sectional survey of the 1,482 active members of the Wisconsin Academy of Family Physicians in 2000. RESULTS A 47% overall response rate was obtained, and 584 respondents could be identified as independent or employed by a health care organization. There were no differences in age or sex between the 2 groups. The independent physicians worked longer hours, were in smaller work groups, and had been in practice longer and in their current practice longer than the employed physicians. Independent physicians reported better working relationships, more satisfaction with family time, more influence over management decisions, better satisfaction with being a physician, better perceived quality of the care they provided, greater ability to achieve professional goals, and lesser intention to leave the practice. CONCLUSIONS Independent physicians have significantly more positive ratings of several aspects of the quality of their work life compared with physicians employed by health care organizations. Health care organizations need to address these issues if they are to have a satisfied and stable workforce

Just What The Doctor Ordered?: The Role Of Cognitive Decision Support Systems In Clinical Decision-Making &Amp; Patient Safety

Human expertise is limited by both cognitive workload and the boundaries of attention. With the spread and integration of healthcare informatics, cognitive decision support (CDS) technologies have been suggested as a means for improving the effectiveness and efficiency of healthcare. The current panel brings together leading human factors and medical experts in the fields of decision-making, design, and human-system interaction to provide their insight and perspective on the following question: What contributions can human factors science bring to bear on (1) the design, (2) integration, and (3) training necessary for effective CDS implementation? Copyright 2010 by Human Factors and Ergonomics Society, Inc. All rights reserved

Health information technology: fallacies and sober realities

Current research suggests that the rate of adoption of health information technology (HIT) is low, and that HIT may not have the touted beneficial effects on quality of care or costs. The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. We discuss 12 HIT fallacies and their implications for design and implementation. These fallacies must be understood and addressed for HIT to yield better results. Foundational cognitive and human factors engineering research and development are essential to better inform HIT development, deployment, and use

Just What the Doctor Ordered?: The Role of Cognitive Decision Support Systems in Clinical Decision-Making & Patient Safety

Human expertise is limited by both cognitive workload and the boundaries of attention. With the spread and integration of healthcare informatics, cognitive decision support (CDS) technologies have been suggested as a means for improving the effectiveness and efficiency of healthcare. The current panel brings together leading human factors and medical experts in the fields of decision-making, design, and human-system interaction to provide their insight and perspective on the following question: What contributions can human factors science bring to bear on (1) the design, (2) integration, and (3) training necessary for effective CDS implementation

Factors affecting home care patients' acceptance of a web-based interactive self-management technology

Objective: With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients' acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive selfmanagement innovation among home care patients. Design: Cross-sectional secondary analysis of data from a randomized field study evaluating a technologyassisted home care nursing practice with adults with chronic cardiac disease. Measurement and analysis A questionnaire was designed based on validated measurement scales from prior research and was completed by 101 participants for measuring the acceptance constructs as part of the parent study protocol. Latent variable modeling with item parceling guided assessment of patients' acceptance. Results: Perceived usefulness accounted for 53.9% of the variability in behavioral intention, the measure of acceptance. Together, perceived usefulness, health care knowledge, and behavioral intention accounted for 68.5% of the variance in perceived effective use. Perceived ease of use and subjective norm indirectly influenced behavioral intention, through perceived usefulness. Perceived ease of use and subjective norm explained 48% of the total variance in perceived usefulness. Conclusion: The study demonstrates that perceived usefulness, perceived ease of use, subjective norm, and healthcare knowledge together predict most of the variance in patients' acceptance and self-reported use of the web-based self-management technology. © 2010 by the American Medical Informatics Association.link_to_OA_fulltex