Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare最新文献
Pub Date : 2023-03-01DOI: 10.1177/2327857923121010
Abdulrahman A Alhaider, Nathan Lau, Paul B. Davenport, Stimis R. Smith, Darrell W. DeWeese
Intrahospital transports rely on effective transmission of information between medical staff and information systems to support Distributed Situation Awareness (DSA) on patient status and transport requirements. This study presents the preliminary results a simulation model combining discrete event simulation (DES) and agent-based modeling (ABM) to quantify SA distribution and transactions for intrahospital transportation. The simulation model captured the transport requests, transport processes, and knowledge distribution and transactions between (human or machine) agents for intrahospital transports. Specifically, this paper presents the simulation results for the successful patient transport from 17 hospital inpatient units to the radiology department for (1) transport times and (2) transport cancellations. One-way t-tests did not reveal any significant differences in average transport time and number of cancelations between outputs of 100 simulation replications and historical data for 18-month operation. These results indicate that the simulation model represents real-world operation that can subsequently be used to test potential intervention to improve DSA in patient flow.
{"title":"Modeling and simulation for situation awareness distribution and transactions for intrahospital patient transports","authors":"Abdulrahman A Alhaider, Nathan Lau, Paul B. Davenport, Stimis R. Smith, Darrell W. DeWeese","doi":"10.1177/2327857923121010","DOIUrl":"https://doi.org/10.1177/2327857923121010","url":null,"abstract":"Intrahospital transports rely on effective transmission of information between medical staff and information systems to support Distributed Situation Awareness (DSA) on patient status and transport requirements. This study presents the preliminary results a simulation model combining discrete event simulation (DES) and agent-based modeling (ABM) to quantify SA distribution and transactions for intrahospital transportation. The simulation model captured the transport requests, transport processes, and knowledge distribution and transactions between (human or machine) agents for intrahospital transports. Specifically, this paper presents the simulation results for the successful patient transport from 17 hospital inpatient units to the radiology department for (1) transport times and (2) transport cancellations. One-way t-tests did not reveal any significant differences in average transport time and number of cancelations between outputs of 100 simulation replications and historical data for 18-month operation. These results indicate that the simulation model represents real-world operation that can subsequently be used to test potential intervention to improve DSA in patient flow.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"40 - 42"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47589598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121003
M. K. Smith, Margaret Dowst, Laura Thomson Farm
{"title":"The Critical Role of Developmental Psychology in Addressing Generational Stereotypes Associated With Use of Digital Health Technologies","authors":"M. K. Smith, Margaret Dowst, Laura Thomson Farm","doi":"10.1177/2327857923121003","DOIUrl":"https://doi.org/10.1177/2327857923121003","url":null,"abstract":"","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"12 - 13"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48988925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121016
Sony Mani, M. Jamil
Across various healthcare systems, serious patient safety issues occur where patients who express Do-Not-Resuscitate (DNR) wishes receive resuscitative measures in error. Our Patient Safety team conducted a common cause analysis and identified contributing factors to such errors, including the unclear display of patients’ code status in the electronic health record (EHR). Our team proposed updated wording for the code status in the EHR and evaluated the proposed design via remote usability testing. Eleven physician and nurse end users participated in 30-minute one-on-one sessions where they consulted EHR screens to respond to simulated patient emergency scenarios. All participants successfully interpreted the updated screens and responded positively to the changes. Following these results, a multidisciplinary team used a Failure Modes and Effects Analysis (FMEA) to guide the successful implementation of the updated design.
{"title":"Cracking The Code: Redesigning EHR Interfaces to Clarify Patients’ End of Life Wishes for Code Situations","authors":"Sony Mani, M. Jamil","doi":"10.1177/2327857923121016","DOIUrl":"https://doi.org/10.1177/2327857923121016","url":null,"abstract":"Across various healthcare systems, serious patient safety issues occur where patients who express Do-Not-Resuscitate (DNR) wishes receive resuscitative measures in error. Our Patient Safety team conducted a common cause analysis and identified contributing factors to such errors, including the unclear display of patients’ code status in the electronic health record (EHR). Our team proposed updated wording for the code status in the EHR and evaluated the proposed design via remote usability testing. Eleven physician and nurse end users participated in 30-minute one-on-one sessions where they consulted EHR screens to respond to simulated patient emergency scenarios. All participants successfully interpreted the updated screens and responded positively to the changes. Following these results, a multidisciplinary team used a Failure Modes and Effects Analysis (FMEA) to guide the successful implementation of the updated design.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"38 11","pages":"61 - 63"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41268378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121036
Helen J. A. Fuller, Kyle D. Maddox, Kathleen Adams, Tim Arnold
A significant body of human factors (HF) work has focused on how people collaborate on teams in various operational settings such as aviation and nuclear power. Less work, however, has focused on the team dynamics of groups conducting HF studies. This paper describes a collaborative effort led by HF practitioners to understand and document user needs and challenges associated with the adoption of a new electronic health record (EHR) at a medical facility. By examining the challenges and opportunities presented by the interdisciplinary nature of the team, we can identify best practices for future study and change management efforts that may ultimately lead to greater organizational maturity and the development of better, safer systems.
{"title":"Considering Team Dynamics during Human Factors Work in Healthcare","authors":"Helen J. A. Fuller, Kyle D. Maddox, Kathleen Adams, Tim Arnold","doi":"10.1177/2327857923121036","DOIUrl":"https://doi.org/10.1177/2327857923121036","url":null,"abstract":"A significant body of human factors (HF) work has focused on how people collaborate on teams in various operational settings such as aviation and nuclear power. Less work, however, has focused on the team dynamics of groups conducting HF studies. This paper describes a collaborative effort led by HF practitioners to understand and document user needs and challenges associated with the adoption of a new electronic health record (EHR) at a medical facility. By examining the challenges and opportunities presented by the interdisciplinary nature of the team, we can identify best practices for future study and change management efforts that may ultimately lead to greater organizational maturity and the development of better, safer systems.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"71 2","pages":"156 - 159"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41272880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121020
Yuhao Chen, Shihui Ruan, K. Plant, Shimeng Du
As Artificial Intelligence (AI) advances, it is included into more and more medical device systems to carry out these systems’ intended functions. Given AI’s ability to learn from real-world use and its capability to continuously improve performance, manufacturers of medical devices are utilizing AI to innovate their products to better assist health care providers. However, like application of other types of medical devices, the application of AI in medical care might pose different types of potential risks to the patients, the users themselves, and to the use environment. For manufactures to successfully ensure the safety of AI medical devices, it is crucial to identify known problems by investigating use-related, user interface, and user interaction in-cidents that have occurred in comparable medical devices. The objective of this study is to identify potential use-related problems of DeepView® Wound Imaging System that assesses the healing potential of thermal burn wounds by analyzing multispectral images with an ML algorithm. We use a variety of sources of information on reports and recalls of medical devices that are associated with deaths, serious injuries and mal-functions. After examining relevant reports and recalls, 19 use-related problems were identified. An in-depth analysis was then conducted, considering each identified use-related problem and determining how it relates to the specific features and functionality of DeepView® Wound Imaging System as well as identifying patterns and commonalities among them. The information gained from this analysis can be beneficial in enhancing the safety of AI medical devices by providing a deeper understanding of the reasons for failure, to avoid similar issues in the future, and ultimately to improve patient safety and public health.
{"title":"Identification of Known Use-Related Problems in Artificial Intelligence Medical Imaging Devices","authors":"Yuhao Chen, Shihui Ruan, K. Plant, Shimeng Du","doi":"10.1177/2327857923121020","DOIUrl":"https://doi.org/10.1177/2327857923121020","url":null,"abstract":"As Artificial Intelligence (AI) advances, it is included into more and more medical device systems to carry out these systems’ intended functions. Given AI’s ability to learn from real-world use and its capability to continuously improve performance, manufacturers of medical devices are utilizing AI to innovate their products to better assist health care providers. However, like application of other types of medical devices, the application of AI in medical care might pose different types of potential risks to the patients, the users themselves, and to the use environment. For manufactures to successfully ensure the safety of AI medical devices, it is crucial to identify known problems by investigating use-related, user interface, and user interaction in-cidents that have occurred in comparable medical devices. The objective of this study is to identify potential use-related problems of DeepView® Wound Imaging System that assesses the healing potential of thermal burn wounds by analyzing multispectral images with an ML algorithm. We use a variety of sources of information on reports and recalls of medical devices that are associated with deaths, serious injuries and mal-functions. After examining relevant reports and recalls, 19 use-related problems were identified. An in-depth analysis was then conducted, considering each identified use-related problem and determining how it relates to the specific features and functionality of DeepView® Wound Imaging System as well as identifying patterns and commonalities among them. The information gained from this analysis can be beneficial in enhancing the safety of AI medical devices by providing a deeper understanding of the reasons for failure, to avoid similar issues in the future, and ultimately to improve patient safety and public health.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"76 - 81"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42712324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121034
Anthony Soung Yee, Laurel Cyr, Carleene Bañez, S. Gelmi, C. Gaulton, Trevor N. T. Hall
This paper describes the collaborative work performed as part of a patient safety and quality improvement choking risk prevention initiative in a specialty mental health hospital in Ontario, Canada. In 2021, Ontario Shores Centre for Mental Health Sciences (Ontario Shores), in collaboration with the Healthcare Insurance Reciprocal of Canada (HIROC), conducted a Failure Modes and Effects Analysis (FMEA) to identify potential failure modes for their choking risk prevention process. “Failure modes” refer to states in a process that have the potential for unintended consequences. The interdisciplinary project team developed and validated a current-state process map, through which identified all opportunities for process improvement. A thematic analysis of the barriers revealed 14 distinct failure modes, each of which were rated along three scales (Severity, Occurrence, and Detectability) to form a ranked list based on Risk Priority Number. As part of a prospective analysis, several system-based and people-based mitigations were generated for each of the failure modes. As a result of the FMEA, Ontario Shores developed, and is in the process of, implementing a choking risk prevention and risk mitigation strategies action plan. In addition, the authors offer some reflections on the collaborative work between the two organizations, in recognition of the opportunity for healthcare organizations to benefit from human factors expertise and principles of applied safety science, usability engineering, and user-centered design.
{"title":"Applying Failure Mode Effects Analysis (FMEA) to Improve Choking Risk Prevention in a Mental Health Setting: Analysis Outcomes and Lessons Learned on Human Factors Collaboration","authors":"Anthony Soung Yee, Laurel Cyr, Carleene Bañez, S. Gelmi, C. Gaulton, Trevor N. T. Hall","doi":"10.1177/2327857923121034","DOIUrl":"https://doi.org/10.1177/2327857923121034","url":null,"abstract":"This paper describes the collaborative work performed as part of a patient safety and quality improvement choking risk prevention initiative in a specialty mental health hospital in Ontario, Canada. In 2021, Ontario Shores Centre for Mental Health Sciences (Ontario Shores), in collaboration with the Healthcare Insurance Reciprocal of Canada (HIROC), conducted a Failure Modes and Effects Analysis (FMEA) to identify potential failure modes for their choking risk prevention process. “Failure modes” refer to states in a process that have the potential for unintended consequences. The interdisciplinary project team developed and validated a current-state process map, through which identified all opportunities for process improvement. A thematic analysis of the barriers revealed 14 distinct failure modes, each of which were rated along three scales (Severity, Occurrence, and Detectability) to form a ranked list based on Risk Priority Number. As part of a prospective analysis, several system-based and people-based mitigations were generated for each of the failure modes. As a result of the FMEA, Ontario Shores developed, and is in the process of, implementing a choking risk prevention and risk mitigation strategies action plan. In addition, the authors offer some reflections on the collaborative work between the two organizations, in recognition of the opportunity for healthcare organizations to benefit from human factors expertise and principles of applied safety science, usability engineering, and user-centered design.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"147 - 150"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41858994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121050
Kathren Pavlov, F. Montalvo, J. Sasser, Luciana Jones, Alexis M. DiBello, D. McConnell, J. Smither
At-home dialysis treatments are becoming increasingly common as suitable options for renal disease treatment. However, the nature of self-administered, at-home dialysis presents specific medical risks and unsupervised patient experiences that require unique attention by health professionals. This study utilized Arhippainen’s ten user experience heuristics to evaluate and identify strengths and weaknesses of at-home dialysis treatments while suggesting methods to improve the at-home patient experience. Results of our heuristic assessment showed that some at-home dialysis providers consider patient needs and consider human factor design aspects. However, patient experience can still be improved by implementing UX principles aimed at providing a satisfying and positive interaction with products and services.
{"title":"Human Factors and User Experience in At-Home Dialysis Treatment Technology and Patient Procedures","authors":"Kathren Pavlov, F. Montalvo, J. Sasser, Luciana Jones, Alexis M. DiBello, D. McConnell, J. Smither","doi":"10.1177/2327857923121050","DOIUrl":"https://doi.org/10.1177/2327857923121050","url":null,"abstract":"At-home dialysis treatments are becoming increasingly common as suitable options for renal disease treatment. However, the nature of self-administered, at-home dialysis presents specific medical risks and unsupervised patient experiences that require unique attention by health professionals. This study utilized Arhippainen’s ten user experience heuristics to evaluate and identify strengths and weaknesses of at-home dialysis treatments while suggesting methods to improve the at-home patient experience. Results of our heuristic assessment showed that some at-home dialysis providers consider patient needs and consider human factor design aspects. However, patient experience can still be improved by implementing UX principles aimed at providing a satisfying and positive interaction with products and services.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"223 - 228"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41550079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121031
Arthur Tung, M. Fan, S. Pinkney, B. Armstrong, Kenneth R Catchpole, P. Trbovich
Preventable intraoperative adverse events (iAEs) may emerge from interactions between multiple work system factors (WSFs) (e.g., technology design, organizational policy, physical environment); these interactions may amplify or dampen patient safety risk. We conducted an exploratory observational study using audiovisual data captured by the Operating Room Black Box to characterize the relationships between associated WSFs. Human factors specialists reviewed video recordings of surgical procedures before transcribing events of interest and classifying them into the relevant WSF categories as defined by the Systems Engineering Initiative for Patient Safety model. Each WSF code was categorized as either a safety threat (ST) or resilience support (RS), and their interactions with associated WSFs were characterized. We transcribed 706 events over 73.5 hours of surgery, and 32 iAEs were identified. We coded 382 STs and 312 RSs, and 249 co-occurring WSF pairings. Co-occurring team (e.g., clear communication, feedback, and leadership) RSs were found to be the most prevalent mechanism to dampen all categories of ST. Co-occurring task (e.g., challenging anatomy) and environment (e.g., disruptive working environments, suboptimal ergonomic monitor setups) STs were the most common risk amplifiers contributing to the occurrence of iAEs. By assessing WSFs in the context of other WSFs, future research may develop interventions that more precisely target risk reduction in the operating room.
{"title":"Amplifiers and Dampeners of Patient Safety Risk in the Operating Room: Interim Analysis of Surgical Video Recorded with the Operating Room Black Box","authors":"Arthur Tung, M. Fan, S. Pinkney, B. Armstrong, Kenneth R Catchpole, P. Trbovich","doi":"10.1177/2327857923121031","DOIUrl":"https://doi.org/10.1177/2327857923121031","url":null,"abstract":"Preventable intraoperative adverse events (iAEs) may emerge from interactions between multiple work system factors (WSFs) (e.g., technology design, organizational policy, physical environment); these interactions may amplify or dampen patient safety risk. We conducted an exploratory observational study using audiovisual data captured by the Operating Room Black Box to characterize the relationships between associated WSFs. Human factors specialists reviewed video recordings of surgical procedures before transcribing events of interest and classifying them into the relevant WSF categories as defined by the Systems Engineering Initiative for Patient Safety model. Each WSF code was categorized as either a safety threat (ST) or resilience support (RS), and their interactions with associated WSFs were characterized. We transcribed 706 events over 73.5 hours of surgery, and 32 iAEs were identified. We coded 382 STs and 312 RSs, and 249 co-occurring WSF pairings. Co-occurring team (e.g., clear communication, feedback, and leadership) RSs were found to be the most prevalent mechanism to dampen all categories of ST. Co-occurring task (e.g., challenging anatomy) and environment (e.g., disruptive working environments, suboptimal ergonomic monitor setups) STs were the most common risk amplifiers contributing to the occurrence of iAEs. By assessing WSFs in the context of other WSFs, future research may develop interventions that more precisely target risk reduction in the operating room.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"130 - 135"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45451311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121040
Kyle D. Maddox, Deborah Ercolini, N. Chumbler, Tim Arnold, Kathleen Adams, Helen J. A. Fuller
Contextual inquiry and discount usability represent a powerful combination of human factors methods as a responsive and rapid approach to better understand end users’ interactions with a new electronic health record (EHR) system as an enterprise capability. Contextual inquiry is an approach to conducting ethnographic field studies and discount usability is a simplified and efficient technique to identify usability issues. This paper describes how the Veterans Health Administration (VHA) Office of Health Informatics Human Factors Engineering (OHI HFE) responded to a request from VHA leadership to provide rapid support to assess EHR post-implementation system performance to discover if there are barriers or shortcomings. The team utilized contextual inquiry methods and principles of discount usability to assess system usability and effectiveness in meeting end-user needs. OHI and the Electronic Health Record Modernization Integration Office (OEHRM IO) formed a team to conduct semi-structured interviews and observations with health care providers at a VHA facility to gather qualitative data showcasing representative users’ experiences with the EHR. The team analyzed the data collected to identify themes and created an affinity map and two service blueprints. It then used this information to produce a report of findings and recommendations. The study identified areas that required remediation, actions that would facilitate success, and opportunities for improvement. Key contributors to the success of this rapid and important effort included the team’s ability to accommodate a compressed schedule by carefully targeting scope; focusing on a smaller number of participants than originally planned; asking direct, targeted questions developed in advance; and capturing data during short interview and observation windows. The data collected also highlights opportunities to continue the use of discount usability methods, when necessary, to continuously improve OHI HFE data collection and achieve targeted quality improvement in a condensed timeframe.
{"title":"Lessons Learned Using Rapid Human Factors Methods: Condensed Timeline with Effective and Impactful Results","authors":"Kyle D. Maddox, Deborah Ercolini, N. Chumbler, Tim Arnold, Kathleen Adams, Helen J. A. Fuller","doi":"10.1177/2327857923121040","DOIUrl":"https://doi.org/10.1177/2327857923121040","url":null,"abstract":"Contextual inquiry and discount usability represent a powerful combination of human factors methods as a responsive and rapid approach to better understand end users’ interactions with a new electronic health record (EHR) system as an enterprise capability. Contextual inquiry is an approach to conducting ethnographic field studies and discount usability is a simplified and efficient technique to identify usability issues. This paper describes how the Veterans Health Administration (VHA) Office of Health Informatics Human Factors Engineering (OHI HFE) responded to a request from VHA leadership to provide rapid support to assess EHR post-implementation system performance to discover if there are barriers or shortcomings. The team utilized contextual inquiry methods and principles of discount usability to assess system usability and effectiveness in meeting end-user needs. OHI and the Electronic Health Record Modernization Integration Office (OEHRM IO) formed a team to conduct semi-structured interviews and observations with health care providers at a VHA facility to gather qualitative data showcasing representative users’ experiences with the EHR. The team analyzed the data collected to identify themes and created an affinity map and two service blueprints. It then used this information to produce a report of findings and recommendations. The study identified areas that required remediation, actions that would facilitate success, and opportunities for improvement. Key contributors to the success of this rapid and important effort included the team’s ability to accommodate a compressed schedule by carefully targeting scope; focusing on a smaller number of participants than originally planned; asking direct, targeted questions developed in advance; and capturing data during short interview and observation windows. The data collected also highlights opportunities to continue the use of discount usability methods, when necessary, to continuously improve OHI HFE data collection and achieve targeted quality improvement in a condensed timeframe.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"174 - 178"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43087185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/2327857923121019
Daniel T. Nystrom, Joel Thomas, Chris Jones
The introduction of continuous cardiac monitoring via telemetry provides a method to ensure patient care is safe and effective. At the same time, the implementation of this technology has raised concerns about telemetry technician (teletech) work. This project provides a two-fold look at teletech’ work in real-time settings to describe teletech interactions with unit staff and to explore the relationship between measures of teletech’ workload and patient load. Results suggest the implementation of telemetry systems necessitate a mutual dependence between teletechs and unit staff: unit staff rely on teletechs to inform them of concerning patient states; teletechs rely on unit staff to maintain the integrity and accuracy of the telemetry system and the patient data they observe. Results from measures of teletech’ workload and patient load align with previous work that explored teletech’ patient load in simulated settings. Agreement between the current project and previous studies also suggest a potential patient load capacity of 33 patients for continuous telemonitoring work. Future research and implications for academics, healthcare operations, and the design of telemetry systems are discussed.
{"title":"Preliminary Evaluation of Cardiac Telemetry Technician Work in a Large Health System: Mutual Dependence and Considerations for Patient Load","authors":"Daniel T. Nystrom, Joel Thomas, Chris Jones","doi":"10.1177/2327857923121019","DOIUrl":"https://doi.org/10.1177/2327857923121019","url":null,"abstract":"The introduction of continuous cardiac monitoring via telemetry provides a method to ensure patient care is safe and effective. At the same time, the implementation of this technology has raised concerns about telemetry technician (teletech) work. This project provides a two-fold look at teletech’ work in real-time settings to describe teletech interactions with unit staff and to explore the relationship between measures of teletech’ workload and patient load. Results suggest the implementation of telemetry systems necessitate a mutual dependence between teletechs and unit staff: unit staff rely on teletechs to inform them of concerning patient states; teletechs rely on unit staff to maintain the integrity and accuracy of the telemetry system and the patient data they observe. Results from measures of teletech’ workload and patient load align with previous work that explored teletech’ patient load in simulated settings. Agreement between the current project and previous studies also suggest a potential patient load capacity of 33 patients for continuous telemonitoring work. Future research and implications for academics, healthcare operations, and the design of telemetry systems are discussed.","PeriodicalId":74550,"journal":{"name":"Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare","volume":"12 1","pages":"71 - 75"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46166834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare. International Symposium of Human Factors and Ergonomics in Healthcare
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