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 : 2022-10-01DOI: 10.1177/2327857922111028
Srinivasan Sridhar, N. Carnegie, Amy Mouat-Hunter, B. McCrory
Background: The Perioperative Surgical Home (PSH) was designed by the American Society of Anesthesiologists (ASA) to improve perioperative care through more coordinated and communicative decision-making. PSH has proven success in large urban health centers by reducing surgery cancellation, operating room time, length of stay (LOS), and readmission rates. Yet, only limited studies have assessed the impact of PSH on surgical outcomes in rural areas. Thus, this study compared surgical outcomes – LOS, discharge disposition, and 90-day readmission – at a rural hospital from cohorts before and after the implementation of PSH. Method: An initial model of a PSH system was initiated in a local rural hospital. This newly created clinical team and outpatient clinic retrospectively assessed total joint surgeries occurring from November 2017 to April 2018 (before PSH, n = 324) as well as from November 2018 to April 2019 (after PSH, n = 326). General linear models were used to understand the impact of PSH on rural surgical outcomes. Results: Implementing PSH had a positive impact on LOS (P-value < 0.01), discharge disposition (P-value < 0.01), and readmission (P-value = 0.03).Conclusion: Implementation of the PSH system in a rural, community hospital reduced LOS, 90-day readmission, and increased direct to home discharge. Increased clinical management standardization across internal and external stakeholders was achieved because the PSH clinic enabled a centralized navigation point for clinicians, patients, and their families to better communicate and coordinate care.
{"title":"A Rural Community Hospital’s Perioperative Surgical Home Model Compared to a Traditional Surgical System","authors":"Srinivasan Sridhar, N. Carnegie, Amy Mouat-Hunter, B. McCrory","doi":"10.1177/2327857922111028","DOIUrl":"https://doi.org/10.1177/2327857922111028","url":null,"abstract":"Background: The Perioperative Surgical Home (PSH) was designed by the American Society of Anesthesiologists (ASA) to improve perioperative care through more coordinated and communicative decision-making. PSH has proven success in large urban health centers by reducing surgery cancellation, operating room time, length of stay (LOS), and readmission rates. Yet, only limited studies have assessed the impact of PSH on surgical outcomes in rural areas. Thus, this study compared surgical outcomes – LOS, discharge disposition, and 90-day readmission – at a rural hospital from cohorts before and after the implementation of PSH. Method: An initial model of a PSH system was initiated in a local rural hospital. This newly created clinical team and outpatient clinic retrospectively assessed total joint surgeries occurring from November 2017 to April 2018 (before PSH, n = 324) as well as from November 2018 to April 2019 (after PSH, n = 326). General linear models were used to understand the impact of PSH on rural surgical outcomes. Results: Implementing PSH had a positive impact on LOS (P-value < 0.01), discharge disposition (P-value < 0.01), and readmission (P-value = 0.03).Conclusion: Implementation of the PSH system in a rural, community hospital reduced LOS, 90-day readmission, and increased direct to home discharge. Increased clinical management standardization across internal and external stakeholders was achieved because the PSH clinic enabled a centralized navigation point for clinicians, patients, and their families to better communicate and coordinate care.","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":"9 1","pages":"140 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86569741","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 : 2022-10-01DOI: 10.1177/2327857922111031
Vikram G. R. Siberry, R. Ratwani, Deliya B. Wesley
Mobile health applications (apps) are increasingly serving as supplement tools to provider-delivered care in various clinical scenarios. This pilot study explored the relationship between readability of in-app privacy policies and patient comprehension of the policy as well as patient preferences regarding data sharing practices and policy content. Based on interviews with individuals with experience and expertise understanding privacy policies (N=5), a list of important patient-relevant content details was generated for each of the two policies used in the study. Patients (N = 5) then determined important content details from their perspective in the same two policies and answered general questions regarding preferences for personal data sharing. The two app policies differed in length and reading difficulty, yet patients only identified 40% of expert-derived content details in each policy. Patients expressed clear preferences for types and purposes of their data being used by apps and method for privacy policy update notification.
{"title":"Mobile Health App Privacy Policies: What Patients Want vs. Understand","authors":"Vikram G. R. Siberry, R. Ratwani, Deliya B. Wesley","doi":"10.1177/2327857922111031","DOIUrl":"https://doi.org/10.1177/2327857922111031","url":null,"abstract":"Mobile health applications (apps) are increasingly serving as supplement tools to provider-delivered care in various clinical scenarios. This pilot study explored the relationship between readability of in-app privacy policies and patient comprehension of the policy as well as patient preferences regarding data sharing practices and policy content. Based on interviews with individuals with experience and expertise understanding privacy policies (N=5), a list of important patient-relevant content details was generated for each of the two policies used in the study. Patients (N = 5) then determined important content details from their perspective in the same two policies and answered general questions regarding preferences for personal data sharing. The two app policies differed in length and reading difficulty, yet patients only identified 40% of expert-derived content details in each policy. Patients expressed clear preferences for types and purposes of their data being used by apps and method for privacy policy update notification.","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":"9 1","pages":"156 - 161"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87509726","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 : 2022-10-01DOI: 10.1177/2327857922111019
Randy Horton, Bob Moll, K. Yew
The medical device industry has a long legacy of product development processes that are heavily influenced by the design of the device hardware. As devices have become connected, often to smartphones via connections such as Bluetooth, software is playing an increasing role in the overall system and in particular the user interface. As a result, iterative agile design practices that are prevalent in software are starting to influence the connected device development process. These modern agile practices put the user at the center of the design problem. But what is the best way in this new world to get feedback from users such that the overall product can be improved? In this paper, we share two techniques, one qualitative and one quantitative, that can answer this question. We’ll also explore the synergy of using both techniques together.
{"title":"The Best of Both Worlds: Using Qualitative and Quantitative Feedback to Improve the Design of Connected Medical Devices","authors":"Randy Horton, Bob Moll, K. Yew","doi":"10.1177/2327857922111019","DOIUrl":"https://doi.org/10.1177/2327857922111019","url":null,"abstract":"The medical device industry has a long legacy of product development processes that are heavily influenced by the design of the device hardware. As devices have become connected, often to smartphones via connections such as Bluetooth, software is playing an increasing role in the overall system and in particular the user interface. As a result, iterative agile design practices that are prevalent in software are starting to influence the connected device development process. These modern agile practices put the user at the center of the design problem. But what is the best way in this new world to get feedback from users such that the overall product can be improved? In this paper, we share two techniques, one qualitative and one quantitative, that can answer this question. We’ll also explore the synergy of using both techniques together.","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":"159 1","pages":"95 - 97"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87883522","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 : 2022-10-01DOI: 10.1177/2327857922111024
Safa Elkefi, Onur Asan, Thy P. Do
Despite the increase in the availability of online technology, the trend of patients’ adoption of health information technology is not yet clear. This study aims to track the temporal evolution of technology adoption among patients. It focuses on studying the impact of technology use on health care services perspective using the self-efficacy theory. We conducted analysis to evaluate trends over time using Nationally representative data. We found that the more people use technology over time, the less effective they perceive health care services. Their use of technology consists of seeking more information online and communicating more with health care providers. Efforts need to be made in order to guide the use of technology as a complement to clinical health care services to ensure a supervision of health behaviors and a framing of health pathway. Future studies should look at the possible designs and concepts that may provide a suitable solution that both satisfy patients and providers’ needs involving technology but keeping traditional health services respectable.
{"title":"Impact of Health Informatics on Patients’ Perception of Health Care Services: Trends over Time of Health Information Technology Use","authors":"Safa Elkefi, Onur Asan, Thy P. Do","doi":"10.1177/2327857922111024","DOIUrl":"https://doi.org/10.1177/2327857922111024","url":null,"abstract":"Despite the increase in the availability of online technology, the trend of patients’ adoption of health information technology is not yet clear. This study aims to track the temporal evolution of technology adoption among patients. It focuses on studying the impact of technology use on health care services perspective using the self-efficacy theory. We conducted analysis to evaluate trends over time using Nationally representative data. We found that the more people use technology over time, the less effective they perceive health care services. Their use of technology consists of seeking more information online and communicating more with health care providers. Efforts need to be made in order to guide the use of technology as a complement to clinical health care services to ensure a supervision of health behaviors and a framing of health pathway. Future studies should look at the possible designs and concepts that may provide a suitable solution that both satisfy patients and providers’ needs involving technology but keeping traditional health services respectable.","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":"15 1","pages":"119 - 124"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89729010","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 : 2022-10-01DOI: 10.1177/2327857922111025
Safa Elkefi, Onur Asan
Wearable devices have potentials for monitoring elderly patients’ health. Many efforts have been made to encourage its use among this population. However, not all of them are succeeding in improving the wearables’ use. In this study, we explored the impact of patient-centered practice in healthcare on wearable devices’ use and the role of this technology use in improving patients’ mental health. We found that a majority of 84.96% of the elderly people who responded to the surveys reported using wearable devices in the last 12 months to monitor or track health activity. For the patient-centered care impact, making sure patients understand next steps and standing by their feelings improve the use of wearable devices (OR=5.95 P=0.011, OR=1.04 P=0.028). However, people who were involved in decision making did not use wearable devices (OR=0.77 P=0.014). For the impact of technology use, wearable users were less likely to experience severe depression and anxiety levels (P=0.0038, OR=0.436). Designers of wearable devices need to create patient-centered features that go with the patients’ needs to ensure the acceptability of this technology.
{"title":"Wearable Devices’ Use in Geriatric Care between Patient-Centeredness and Psychology of Patients","authors":"Safa Elkefi, Onur Asan","doi":"10.1177/2327857922111025","DOIUrl":"https://doi.org/10.1177/2327857922111025","url":null,"abstract":"Wearable devices have potentials for monitoring elderly patients’ health. Many efforts have been made to encourage its use among this population. However, not all of them are succeeding in improving the wearables’ use. In this study, we explored the impact of patient-centered practice in healthcare on wearable devices’ use and the role of this technology use in improving patients’ mental health. We found that a majority of 84.96% of the elderly people who responded to the surveys reported using wearable devices in the last 12 months to monitor or track health activity. For the patient-centered care impact, making sure patients understand next steps and standing by their feelings improve the use of wearable devices (OR=5.95 P=0.011, OR=1.04 P=0.028). However, people who were involved in decision making did not use wearable devices (OR=0.77 P=0.014). For the impact of technology use, wearable users were less likely to experience severe depression and anxiety levels (P=0.0038, OR=0.436). Designers of wearable devices need to create patient-centered features that go with the patients’ needs to ensure the acceptability of this technology.","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":"16 1","pages":"125 - 128"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73297526","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 : 2022-10-01DOI: 10.1177/2327857922111027
Megan E. Salwei, M. Sesto, Amye J. Tevaarwerk, Cibele B. Carroll
Metastatic breast cancer (MBC) is incurable breast cancer (i.e., stage IV) affecting approximately 165,000 women in the US, some of whom will live for years with MBC. Survivors living with MBC frequently experience functional impairments and sickness relating to treatment and their disease progression. Unlike “curable” cancers, MBC survivors are likely to deal with ongoing and/or evolving impairments due to cancer and cancer treatment until end of life, which presents challenges to work and employment. Little is known about the work-related needs of MBC survivors and the factors that impact individual survivors’ decisions to stay-or-leave work. The objective of this study is to understand the work system barriers and facilitators facing MBC survivors who were working at the time of MBC diagnosis. We conducted a survey of MBC survivors as a part of a larger research project to explore the importance of work and work-related decisions in this population. We conducted a secondary, deductive content analysis of a free-text response survey question guided by the Work System model. We identified a total of 77 excerpts, grouped into 12 barriers and 5 facilitators from survey responses of 133 MBC survivors. The person work system element resulted in the most barriers and facilitators, with numerous barriers relating to a lack of information available for MBC survivors. We only identified one excerpt relating to the technology work system element. Given the rapidly growing capabilities of technologies, there is a missed opportunity to design technologies that can support MBC survivors. The increased use of dedicated personnel (e.g., social work, navigators or financial counselors) and the development of patient-facing health IT may better support the unique needs of MBC survivors.
{"title":"Unmet Employment Related Needs of Metastatic Breast Cancer Survivors: A Work System Analysis","authors":"Megan E. Salwei, M. Sesto, Amye J. Tevaarwerk, Cibele B. Carroll","doi":"10.1177/2327857922111027","DOIUrl":"https://doi.org/10.1177/2327857922111027","url":null,"abstract":"Metastatic breast cancer (MBC) is incurable breast cancer (i.e., stage IV) affecting approximately 165,000 women in the US, some of whom will live for years with MBC. Survivors living with MBC frequently experience functional impairments and sickness relating to treatment and their disease progression. Unlike “curable” cancers, MBC survivors are likely to deal with ongoing and/or evolving impairments due to cancer and cancer treatment until end of life, which presents challenges to work and employment. Little is known about the work-related needs of MBC survivors and the factors that impact individual survivors’ decisions to stay-or-leave work. The objective of this study is to understand the work system barriers and facilitators facing MBC survivors who were working at the time of MBC diagnosis. We conducted a survey of MBC survivors as a part of a larger research project to explore the importance of work and work-related decisions in this population. We conducted a secondary, deductive content analysis of a free-text response survey question guided by the Work System model. We identified a total of 77 excerpts, grouped into 12 barriers and 5 facilitators from survey responses of 133 MBC survivors. The person work system element resulted in the most barriers and facilitators, with numerous barriers relating to a lack of information available for MBC survivors. We only identified one excerpt relating to the technology work system element. Given the rapidly growing capabilities of technologies, there is a missed opportunity to design technologies that can support MBC survivors. The increased use of dedicated personnel (e.g., social work, navigators or financial counselors) and the development of patient-facing health IT may better support the unique needs of MBC survivors.","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":"41 1","pages":"135 - 139"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80562988","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 : 2022-10-01DOI: 10.1177/2327857922111023
Avishek Choudhury, Onur Asan
The rapid digitization of health care during the Covid-19 pandemic has increased the concern of the ‘digital divide,’ particularly for older adults. This study captures the trend of technology use among older populations before and during the Covid-19 pandemic. The study also measures the impact of the pandemic, healthcare technologies, and health status on older adults’ likelihood of communicating with the doctors, making independent treatment decisions, and achieving health-related goals. According to the study, older adults during the Covid-19 pandemic were less likely to communicate with their doctors or achieve their health-related goals by a factor of 1.158 and 1.130, respectively. Older adults who had depression were more likely to make independent treatment-related decisions by a factor of 0.744. We noted an increased usage of mHealth appli- cations and the internet during the Covid-19 pandemic. However, fewer people had access to smartphones and tablet computers. We also reported a significant increase in the proportion of older adults who did not use or understand online medical records over the years. The study emphasizes that as more older adults adopt technology, it is imperative to consider human factors’ methodologies and considerations. Authorities should consider technology affordance and affordability for patients across various socio-economic gradients and with different physical and cognitive capabilities.
{"title":"Use of Technology for Health-Related Tasks among Older Adults: Trend Analysis of Pre-&-during COVID","authors":"Avishek Choudhury, Onur Asan","doi":"10.1177/2327857922111023","DOIUrl":"https://doi.org/10.1177/2327857922111023","url":null,"abstract":"The rapid digitization of health care during the Covid-19 pandemic has increased the concern of the ‘digital divide,’ particularly for older adults. This study captures the trend of technology use among older populations before and during the Covid-19 pandemic. The study also measures the impact of the pandemic, healthcare technologies, and health status on older adults’ likelihood of communicating with the doctors, making independent treatment decisions, and achieving health-related goals. According to the study, older adults during the Covid-19 pandemic were less likely to communicate with their doctors or achieve their health-related goals by a factor of 1.158 and 1.130, respectively. Older adults who had depression were more likely to make independent treatment-related decisions by a factor of 0.744. We noted an increased usage of mHealth appli- cations and the internet during the Covid-19 pandemic. However, fewer people had access to smartphones and tablet computers. We also reported a significant increase in the proportion of older adults who did not use or understand online medical records over the years. The study emphasizes that as more older adults adopt technology, it is imperative to consider human factors’ methodologies and considerations. Authorities should consider technology affordance and affordability for patients across various socio-economic gradients and with different physical and cognitive capabilities.","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":"33 1","pages":"113 - 118"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83107024","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 : 2022-10-01DOI: 10.1177/2327857922111014
Myrtede C. Alfred, Dulaney A. Wilson
Pregnancy related deaths are elevated among women of color, and Black women are 3 to 4 times more likely to die from pregnancy-related causes than white women. Women of color also experience higher rates of severe maternal morbidity (SMM). Half of all maternal deaths and SMM cases are considered preventable with timely and appropriate care. Poor maternal health outcomes and racial/ethnic disparities are the result of multilevel variables including poor quality of care. Few studies have investigated the underlying mechanisms within clinical systems that undermine safety for women of color. This research investigates systems issues contributing to adverse outcomes in maternal care and disparities based on the examination of patient safety incidents (PSIs) reported in the obstetric care units in a large, academic health system in 2019 and 2020. Trends in event type and harm score were examined and the data was disaggregated by race/ethnicity and cross tabulated with unit, event type, and harm score to examine disparities in adverse events. Of the 693 reported incidents, non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients accounted for 43.8% each. Hispanic patients accounted for 7.9% of reported incidents and patients categorized as “Other” accounted for 4.3% of the reported incidents. In both 2019 and 2020, the odds ratio demonstrated a higher likelihood of a reported event for non-Hispanic Black patients (1.99, 95%CI, 1.56 -2.52 and 1.70, 95% CI 1.28-2.25, respectively) and patients categorized as “Other” (15.34, 95% CI 7.25-32.44 and 4.43, 95%CI 1.85-10.58). These findings can facilitate the identification of mechanisms within the clinical system contributing to variation in adverse outcomes for women of color and support the design of more precise interventions and sustained, effective delivery.
{"title":"Adverse Events in Maternal Care: Investigating Racial/Ethnic Disparities at the System Level","authors":"Myrtede C. Alfred, Dulaney A. Wilson","doi":"10.1177/2327857922111014","DOIUrl":"https://doi.org/10.1177/2327857922111014","url":null,"abstract":"Pregnancy related deaths are elevated among women of color, and Black women are 3 to 4 times more likely to die from pregnancy-related causes than white women. Women of color also experience higher rates of severe maternal morbidity (SMM). Half of all maternal deaths and SMM cases are considered preventable with timely and appropriate care. Poor maternal health outcomes and racial/ethnic disparities are the result of multilevel variables including poor quality of care. Few studies have investigated the underlying mechanisms within clinical systems that undermine safety for women of color. This research investigates systems issues contributing to adverse outcomes in maternal care and disparities based on the examination of patient safety incidents (PSIs) reported in the obstetric care units in a large, academic health system in 2019 and 2020. Trends in event type and harm score were examined and the data was disaggregated by race/ethnicity and cross tabulated with unit, event type, and harm score to examine disparities in adverse events. Of the 693 reported incidents, non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients accounted for 43.8% each. Hispanic patients accounted for 7.9% of reported incidents and patients categorized as “Other” accounted for 4.3% of the reported incidents. In both 2019 and 2020, the odds ratio demonstrated a higher likelihood of a reported event for non-Hispanic Black patients (1.99, 95%CI, 1.56 -2.52 and 1.70, 95% CI 1.28-2.25, respectively) and patients categorized as “Other” (15.34, 95% CI 7.25-32.44 and 4.43, 95%CI 1.85-10.58). These findings can facilitate the identification of mechanisms within the clinical system contributing to variation in adverse outcomes for women of color and support the design of more precise interventions and sustained, effective delivery.","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":"54 1","pages":"70 - 75"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77384285","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 : 2022-10-01DOI: 10.1177/2327857922111020
Hand sanitization by healthcare staff remains one of the most effective ways for controlling infection in healthcare settings. However, predicting faithful adherence to Hand Hygiene Compliance (HHC) is difficult in complex environments such as inpatient hospital settings. The main challenge is understanding how different components of human and built systems interact to achieve specific goals such as HHC at the critical moments of care delivery. The aim of this explorative study was to evaluate how Human Factors derived visual salience cues and proximity-compatibility principles might be used in the design of healthcare spaces to support nurse moments of HHC through increased perceived behavioral control and intention. The investigative team used a Collaborative Computational Scenario Planning (CCSP) Model approach to determine the integrative effects of reinforcing and detracting operational and environmental factors on discrete moments of HHC behavior. Supervised Machine Learning analysis was conducted on data collected by a large academic medical center that included HHC observance in clinical staff spanning from 2017 to 2021 in two inpatient hospital units. The probabilistic outcomes of unit based HHC observance likelihood were used to compute Fuzzy Cognitive Model Edge Probabilities between Hand Hygiene (HH) cues and detected HHC at key moments. Hospital infection control experts were then engaged to identify the weight of various reinforcing and detracting operational and environmental factors contributing to HHC observance. Combining the quantitative and qualitative methods, allowed the team to then develop integrative CCSP models which facilitated predictive insight into the development of targeted environmental improvements that might contribute to HHC control and intention to support safer patient care.
{"title":"Improving Hand Hygiene Compliance through Collaborative Computational Design","authors":"","doi":"10.1177/2327857922111020","DOIUrl":"https://doi.org/10.1177/2327857922111020","url":null,"abstract":"Hand sanitization by healthcare staff remains one of the most effective ways for controlling infection in healthcare settings. However, predicting faithful adherence to Hand Hygiene Compliance (HHC) is difficult in complex environments such as inpatient hospital settings. The main challenge is understanding how different components of human and built systems interact to achieve specific goals such as HHC at the critical moments of care delivery. The aim of this explorative study was to evaluate how Human Factors derived visual salience cues and proximity-compatibility principles might be used in the design of healthcare spaces to support nurse moments of HHC through increased perceived behavioral control and intention. The investigative team used a Collaborative Computational Scenario Planning (CCSP) Model approach to determine the integrative effects of reinforcing and detracting operational and environmental factors on discrete moments of HHC behavior. Supervised Machine Learning analysis was conducted on data collected by a large academic medical center that included HHC observance in clinical staff spanning from 2017 to 2021 in two inpatient hospital units. The probabilistic outcomes of unit based HHC observance likelihood were used to compute Fuzzy Cognitive Model Edge Probabilities between Hand Hygiene (HH) cues and detected HHC at key moments. Hospital infection control experts were then engaged to identify the weight of various reinforcing and detracting operational and environmental factors contributing to HHC observance. Combining the quantitative and qualitative methods, allowed the team to then develop integrative CCSP models which facilitated predictive insight into the development of targeted environmental improvements that might contribute to HHC control and intention to support safer patient care.","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":"107 1","pages":"98 - 103"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79321828","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 : 2022-10-01DOI: 10.1177/2327857922111030
Maryam Attef, Catherine Dulude, Chantal M. J. Trudel, Melanie Buba
Family-centered rounds (FCR) are multidisciplinary rounds, involving patients and caregivers with the aim of shared decision making in medical care planning. In response to the COVID-19 pandemic, a tertiary care pediatric hospital re-engineered the in-person FCR process used by inpatient Pediatric Medicine teams implemented virtual family-centered rounds (vFCR). As part of a mixed methods study evaluating vFCR, naturalistic observation was used to evaluate the usability of vFCR technology. Functional and user requirements were assessed and confirmed through observation of interactions with technology intended to support vFCR. The duration of individual patient rounds and transition time between patients was also captured. Technology interactions were assessed in terms of what worked (successful interactions) and what did not work (usability issues and errors). Neilsen and Norman’s (1994) usability heuristics were used to support the evaluation and explanation of findings. While naturalistic observation yielded clear results in terms of effectiveness and efficiency, user satisfaction was not formally examined. The identified usability requirements and key characteristics for ease of use and adoption of vFCR identified in this study can be used by other hospitals looking to implement or improve inpatient virtual care technology usability.
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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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