Siddarth Ponnala - Academia.edu (original) (raw)
Papers by Siddarth Ponnala
Health Informatics, 2019
Patient-oriented workflow refers to decoupling workflow from the personnel who work in formal set... more Patient-oriented workflow refers to decoupling workflow from the personnel who work in formal settings and coupling it, instead, to the patient, who is at the center of all work and who spans all settings, formal and informal. Patient-oriented workflow provides a holistic perspective that can inform the design of health information technology, organizational design, implementation and evaluation efforts. Both qualitative and quantitative methods can be used to study patient-oriented workflow. In this chapter we presented the use of patient-oriented workflow in various settings including emergency departments, daily living environments, nursing homes and skilled home health care. To successfully redesign healthcare delivery, as well as design and implement HIT that can account for care across the entire patient journey, healthcare delivery must be examined as an integrated system of a longitudinal process rather than a cluster of discrete tasks/processes in isolated environments. Pat...
Hospital Pediatrics
BACKGROUND AND OBJECTIVES Physiologic monitor alarms occur at high rates in children’s hospitals;... more BACKGROUND AND OBJECTIVES Physiologic monitor alarms occur at high rates in children’s hospitals; ≤1% are actionable. The burden of alarms has implications for patient safety and is challenging to measure directly. Nurse workload, measured by using a version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) validated among nurses, is a useful indicator of work burden that has been associated with patient outcomes. A recent study revealed that 5-point increases in the NASA-TLX score were associated with a 22% increased risk in missed nursing care. Our objective was to measure the relationship between alarm count and nurse workload by using the NASA-TLX. METHODS We conducted a repeated cross-sectional study of pediatric nurses in a tertiary care children’s hospital to measure the association between NASA-TLX workload evaluations (using the nurse-validated scale) and alarm count in the 2 hours preceding NASA-TLX administration. Using a multivariable mixed-...
Comprehensive Healthcare Simulation
Healthcare systems are complex and dynamic in nature and are driven by many interactions between ... more Healthcare systems are complex and dynamic in nature and are driven by many interactions between system factors and processes to shape outcomes. Much of the complexity can be attributed to the interactions between system elements that influence healthcare delivery. In this chapter, we describe several conceptual frameworks that have been developed specifically to study and analyze interactions in healthcare systems. Many of the frameworks are supplemented with examples to illustrate successful use cases. Additionally, we provide various analytical and design tools that may be employed independently or collectively to identify barriers and facilitators to achieving desired outcomes with healthcare processes in complex systems.
International Journal of Medical Informatics
INTRODUCTION AND PURPOSE Informal caregivers of persons living with dementia have significant unm... more INTRODUCTION AND PURPOSE Informal caregivers of persons living with dementia have significant unmet information needs that, if met, would better equip them to provide effective care. Despite the existence of health information technologies, websites, resources, and organizations dedicated to dementia caregiving, caregivers continue to report unmet information needs. Caregivers' continued unmet information needs suggest a misalignment between information products, and caregivers' information behavior-how caregivers generate, acquire, manage, use, communicate, and seek information. Researchers have developed conceptual models for understanding caregivers' information behavior, but these models are limited in that they are task-oriented, and they assume that caregivers' information needs will be met if they engage in information behavior. To address these limitations, the present study sought to explore caregivers' information behavior as a sociotechnical-systems-based process. METHODS We conduced semi-structured interviews with 30 self-identified caregivers to explore their daily experience of caregiving activities, including their information behavior. We applied a process-based conceptual framework that takes into account inputs, processes, outputs, and feedback mechanisms within a sociotechnical system to guide analysis. The process of interest was caregivers' information behavior as modeled by the information-seeking and communication model (ISCM). We conducted a deductive content analysis guided by the components of the ISCM. We then used team-based affinity diagramming to collapse and categorize the ISCM components into inputs, processes, outputs, and feedback. RESULTS We developed a conceptual model to depict caregivers' information behavior as a sociotechnical-systems-based process of inputs, processes, and outputs that feedback into the system. The conceptual model consisted of three inputs (i.e., information users, information providers, and information products), three information seeking and communication processes (i.e., information access, information interaction, and information assessment and processing), two outputs (i.e., utility and credibility), and feedback. DISCUSSION AND CONCLUSION Building on and addressing the gaps in previous information behavior models, our conceptual framework advances the previous task-level understandings of caregivers' information behavior into a comprehensive feedback-driven, process-level perspective consisting of context-based inputs, information seeking and communication processes, outputs, and feedback. A sociotechnical-systems-based understanding of caregivers' information behavior allows for misalignments between information providers and products, and caregivers' information behavior not only to be illuminated, but systematically addressed.
Journal of Surgical Research
Ergonomics in Design: The Quarterly of Human Factors Applications
Hand hygiene is an essential component of infection prevention in the health care setting. Despit... more Hand hygiene is an essential component of infection prevention in the health care setting. Despite diligent efforts, clinicians can be susceptible to hand hygiene misses in fast-paced, complex environments such as the operating room due to systemic factors such as the physical environment, workflow, and sporadic interactions with other personnel. Through the use of human factors and resilience engineering concepts, work-as-done were studied to identify barriers to hand hygiene compliance in the operating rooms of a pediatric hospital in an urban area. The saliency, effort, expectancy, value model was applied to design a multifaceted intervention that resulted in a sustained 95% hand hygiene compliance.
International Journal for Quality in Health Care
Purpose To demonstrate the use and value of the Human Factors/Ergonomics-based Systems Engineerin... more Purpose To demonstrate the use and value of the Human Factors/Ergonomics-based Systems Engineering Initiative for Patient Safety (SEIPS) family of work system models for studying and improving patient work. Data Sources : We conducted a review of the published empirical literature applying the SEIPS family of work system models for patient work. Study Selection Included studies had to: apply one of the SEIPS family of work system models to study patient work; be published in a peer-reviewed journal in English; and include analysis of data. We identified 16 articles that met our inclusion criteria. Data Extraction For each study we extracted: settings and situations in which models were applied; research design; study methods; model(s) used; type and number of study participants; study objective(s); whether the study included an intervention; specific aspects of the model used; knowledge generated about patient work; and benefits of using the models. Results of data synthesis Our ana...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Healthcare systems have begun to recognize the value of Human Factors and Ergonomics (HFE) and ha... more Healthcare systems have begun to recognize the value of Human Factors and Ergonomics (HFE) and have started to create dedicated roles within their organizational structure for HFE practitioners and researchers to work with safety and quality groups to enhance safety, productivity, and overall system efficiencies. This panel brings together HFE personnel from different organizations, who will share their experiences working with clinical partners, in healthcare systems. Specifically, the panelists will lead an interactive discussion with audience members on strategies for changing the safety culture required to achieve the status of a high reliability organization (HRO). The panel will also share methods for demonstrating return on investment for HFE and techniques for successful implementation to continue the long-term integration of HFE into safety and quality improvement projects within healthcare organizations.
Applied Ergonomics
Informal caregivers are an integral part of care delivery for persons with dementia (PwD). Inform... more Informal caregivers are an integral part of care delivery for persons with dementia (PwD). Informal caregivers take part in a wide range of care activities both individually and collaboratively with other caregivers. Caregiving often involves high demands in the face of limited resources, which can lead to stress, burden, and burnout. To support caregivers, we need to conceptualize caregiving activities they perform, and the networks and roles through which they perform work. We performed a directed content analysis on interview data from twenty caregivers and applied a human factors approach to characterize informal caregiving work. Our results revealed 1) nuances in caregiving roles, 2) differences in caregiving networks, and 3) 13 categories of caregiving activities characterized by time commitments; physical, cognitive and socio-behavioral demands; and varying network dependencies. These findings can be applied in future studies to evaluate the needs of caregiving networks and how to better support them.
Journal of Surgical Education
OBJECTIVE With recent changes to graduate medical education, the balance between resident autonom... more OBJECTIVE With recent changes to graduate medical education, the balance between resident autonomy and need for supervision impacts the educational and training experience of residents. The objective of this study was to understand the relationship between the confidence of attendings and residents and their different perspectives of perceived educational experience and autonomy in the operating room (OR). We hypothesized that the attending's confidence in the resident would be an important factor in improving the educational experience and resident's autonomy in the OR. DESIGN Self-reported confidence-rating and operative experience surveys were administered to teams of post-graduate year (PGY 1) through PGY 5 surgical residents and attendings in two temporal sets (Early: Sept-Dec 2015, n = 20; Late: Jan-Apr 2016, n = 22). A second "end-of-year" survey was distributed to residents (n = 9, 37.5% response) and attendings (n = 10, 35% response) asking questions regarding their educational experience and operative experience during the past year. SETTING Large rural teaching hospital. PARTICIPANTS Nineteen general surgery residents (PGY 1 - 5) and 14 general surgery attendings. RESULTS Resident perception of confidence differs from junior to senior residents, and that there was discordance between resident's confidence and skill as perceived by attendings, particularly in senior residents. Results also showed that attending's confidence in residents was positively correlated with attending's perceived educational experience in the OR. Residents and attendings both indicated attending's confidence in residents as an important factor in increasing resident autonomy in the OR, thus the attending's confidence in residents could have a positive impact on resident autonomy and educational experience in the OR. CONCLUSIONS We have demonstrated a relationship between self-confidence for residents and improved confidence from attendings in residents' capabilities. Based on these findings, we would propose identifying methods to expand resident's awareness of surgical situations and develop attending's confidence in residents.
Surgical Endoscopy
BackgroundEye-gaze metrics derived from areas of interest (AOIs) have been suggested to be effect... more BackgroundEye-gaze metrics derived from areas of interest (AOIs) have been suggested to be effective for surgical skill assessment. However, prior research is mostly based on static images and simulated tasks that may not translate to complex and dynamic surgical scenes. Therefore, eye-gaze metrics must advance to account for changes in the location of important information during a surgical procedure.MethodsWe developed a dynamic AOI generation technique based on eye gaze collected from an expert viewing surgery videos. This AOI updated as the gaze of the expert moved with changes in the surgical scene. This technique was evaluated through an experiment recruiting a total of 20 attendings and residents to view 10 videos associated with and another 10 without adverse events.ResultsDwell time percentage (i.e., gaze duration) inside the AOI differentiated video type (U = 13508.5, p < 0.001) between videos with the presence (Mdn = 16.75) versus absence (Mdn = 19.95) of adverse events. This metric also differentiated participant group (U = 14029.5, p < 0.001) between attendings (Mdn = 15.45) and residents (Mdn = 19.80). This indicates that our dynamic AOIs reflecting the expert eye gaze was able to differentiate expertise, and the presence of unexpected adverse events.ConclusionThis dynamic AOI generation technique produced dynamic AOIs for deriving eye-gaze metrics that were sensitive to expertise level and event characteristics.
Current Treatment Options in Pediatrics
Purpose of ReviewHuman Factors Engineering (HFE) has had much success in research initiatives to ... more Purpose of ReviewHuman Factors Engineering (HFE) has had much success in research initiatives to identify socio-technical system barriers to improve patient and employee safety and healthcare quality. However, there have only been a few applications of HFE, in which research is translated into practice, and has been implemented in an organization. This paper presents a systematic review of HFE interventions that have been implemented to improve healthcare quality and patient safety, specific to the pediatric population. This paper also discusses the current status of HFE in healthcare and how the science of HFE can be further applied to improve safety in healthcare delivery processes.Recent FindingsIn the last few years, HFE has been applied in many different areas in healthcare. These areas include EHR design, imaging, medication management, patient experience, and care transitions. The interventions include a combination of cognitive, physical, and macroergonomics principles to improve healthcare delivery for pediatric populations.SummaryThis systematic review identifies 28 peer-reviewed articles that have applied HFE in design, development, and implementation of an intervention to improve safety and/or quality for the pediatric population. The articles employ quantitative, qualitative, or mixed methods to assess the effectiveness, acceptability, and sustainability of the intervention.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Introduction Although an understanding of the patient work system has been increasing in the fiel... more Introduction Although an understanding of the patient work system has been increasing in the field of Ergonomics and Human Factors, the role of informal caregivers (unpaid, nonprofessional caregivers) within the patient work system remains largely unexplored (Holden, Schubert, & Mickelson, 2015; Holden, Valdez, Schubert, Thompson, & Hundt, 2017). Informal caregivers include the family members and friends of persons with dementia (PwD), or anyone else who is unpaid, and a non-professional caregiver for a PWD(Reinhard, Given, Petlick, & Bemis, 2008). Nevertheless, informal caregivers are often unsupported and lack guidance with caregiving activities(Alrashed, 2017; Bossen, Christensen, Grönvall, & Vestergaard, 2013). This study represents a first step to define the work of informal caregivers, identify variations in caregiver involvement across multiple caregivers, and explore the perceptions of the primary caregiver (PC) regarding the care network. Understanding the specific roles an...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Persons with dementia (PwD) are an increasing population that are becoming more dependent on info... more Persons with dementia (PwD) are an increasing population that are becoming more dependent on informal caregivers. Thus, caregiver workload is becoming a national concern due to the amount of patient work associated with caregiving. While we have a rudimentary understanding of caregiving work demands, caregiving capacity is an area that needs further inquiry. In this study, we apply a macroergonomic approach to identify non-cognitive resources employed by caregivers, and contingencies for caregivers’ resource usage. We conducted 30 semi-structured interviews with self-identified primary caregivers of persons with dementia. Using the patient work system model, we conducted content and thematic analyses of interview data to build a conceptual model of caregiving capacity. Our conceptual model includes 6 different resources channels that caregivers may activate. We also identified 3 contingencies of resource usage. This model can serve as a foundation for exploring distribution of careg...
Health Informatics, 2019
Patient-oriented workflow refers to decoupling workflow from the personnel who work in formal set... more Patient-oriented workflow refers to decoupling workflow from the personnel who work in formal settings and coupling it, instead, to the patient, who is at the center of all work and who spans all settings, formal and informal. Patient-oriented workflow provides a holistic perspective that can inform the design of health information technology, organizational design, implementation and evaluation efforts. Both qualitative and quantitative methods can be used to study patient-oriented workflow. In this chapter we presented the use of patient-oriented workflow in various settings including emergency departments, daily living environments, nursing homes and skilled home health care. To successfully redesign healthcare delivery, as well as design and implement HIT that can account for care across the entire patient journey, healthcare delivery must be examined as an integrated system of a longitudinal process rather than a cluster of discrete tasks/processes in isolated environments. Pat...
Hospital Pediatrics
BACKGROUND AND OBJECTIVES Physiologic monitor alarms occur at high rates in children’s hospitals;... more BACKGROUND AND OBJECTIVES Physiologic monitor alarms occur at high rates in children’s hospitals; ≤1% are actionable. The burden of alarms has implications for patient safety and is challenging to measure directly. Nurse workload, measured by using a version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) validated among nurses, is a useful indicator of work burden that has been associated with patient outcomes. A recent study revealed that 5-point increases in the NASA-TLX score were associated with a 22% increased risk in missed nursing care. Our objective was to measure the relationship between alarm count and nurse workload by using the NASA-TLX. METHODS We conducted a repeated cross-sectional study of pediatric nurses in a tertiary care children’s hospital to measure the association between NASA-TLX workload evaluations (using the nurse-validated scale) and alarm count in the 2 hours preceding NASA-TLX administration. Using a multivariable mixed-...
Comprehensive Healthcare Simulation
Healthcare systems are complex and dynamic in nature and are driven by many interactions between ... more Healthcare systems are complex and dynamic in nature and are driven by many interactions between system factors and processes to shape outcomes. Much of the complexity can be attributed to the interactions between system elements that influence healthcare delivery. In this chapter, we describe several conceptual frameworks that have been developed specifically to study and analyze interactions in healthcare systems. Many of the frameworks are supplemented with examples to illustrate successful use cases. Additionally, we provide various analytical and design tools that may be employed independently or collectively to identify barriers and facilitators to achieving desired outcomes with healthcare processes in complex systems.
International Journal of Medical Informatics
INTRODUCTION AND PURPOSE Informal caregivers of persons living with dementia have significant unm... more INTRODUCTION AND PURPOSE Informal caregivers of persons living with dementia have significant unmet information needs that, if met, would better equip them to provide effective care. Despite the existence of health information technologies, websites, resources, and organizations dedicated to dementia caregiving, caregivers continue to report unmet information needs. Caregivers' continued unmet information needs suggest a misalignment between information products, and caregivers' information behavior-how caregivers generate, acquire, manage, use, communicate, and seek information. Researchers have developed conceptual models for understanding caregivers' information behavior, but these models are limited in that they are task-oriented, and they assume that caregivers' information needs will be met if they engage in information behavior. To address these limitations, the present study sought to explore caregivers' information behavior as a sociotechnical-systems-based process. METHODS We conduced semi-structured interviews with 30 self-identified caregivers to explore their daily experience of caregiving activities, including their information behavior. We applied a process-based conceptual framework that takes into account inputs, processes, outputs, and feedback mechanisms within a sociotechnical system to guide analysis. The process of interest was caregivers' information behavior as modeled by the information-seeking and communication model (ISCM). We conducted a deductive content analysis guided by the components of the ISCM. We then used team-based affinity diagramming to collapse and categorize the ISCM components into inputs, processes, outputs, and feedback. RESULTS We developed a conceptual model to depict caregivers' information behavior as a sociotechnical-systems-based process of inputs, processes, and outputs that feedback into the system. The conceptual model consisted of three inputs (i.e., information users, information providers, and information products), three information seeking and communication processes (i.e., information access, information interaction, and information assessment and processing), two outputs (i.e., utility and credibility), and feedback. DISCUSSION AND CONCLUSION Building on and addressing the gaps in previous information behavior models, our conceptual framework advances the previous task-level understandings of caregivers' information behavior into a comprehensive feedback-driven, process-level perspective consisting of context-based inputs, information seeking and communication processes, outputs, and feedback. A sociotechnical-systems-based understanding of caregivers' information behavior allows for misalignments between information providers and products, and caregivers' information behavior not only to be illuminated, but systematically addressed.
Journal of Surgical Research
Ergonomics in Design: The Quarterly of Human Factors Applications
Hand hygiene is an essential component of infection prevention in the health care setting. Despit... more Hand hygiene is an essential component of infection prevention in the health care setting. Despite diligent efforts, clinicians can be susceptible to hand hygiene misses in fast-paced, complex environments such as the operating room due to systemic factors such as the physical environment, workflow, and sporadic interactions with other personnel. Through the use of human factors and resilience engineering concepts, work-as-done were studied to identify barriers to hand hygiene compliance in the operating rooms of a pediatric hospital in an urban area. The saliency, effort, expectancy, value model was applied to design a multifaceted intervention that resulted in a sustained 95% hand hygiene compliance.
International Journal for Quality in Health Care
Purpose To demonstrate the use and value of the Human Factors/Ergonomics-based Systems Engineerin... more Purpose To demonstrate the use and value of the Human Factors/Ergonomics-based Systems Engineering Initiative for Patient Safety (SEIPS) family of work system models for studying and improving patient work. Data Sources : We conducted a review of the published empirical literature applying the SEIPS family of work system models for patient work. Study Selection Included studies had to: apply one of the SEIPS family of work system models to study patient work; be published in a peer-reviewed journal in English; and include analysis of data. We identified 16 articles that met our inclusion criteria. Data Extraction For each study we extracted: settings and situations in which models were applied; research design; study methods; model(s) used; type and number of study participants; study objective(s); whether the study included an intervention; specific aspects of the model used; knowledge generated about patient work; and benefits of using the models. Results of data synthesis Our ana...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Healthcare systems have begun to recognize the value of Human Factors and Ergonomics (HFE) and ha... more Healthcare systems have begun to recognize the value of Human Factors and Ergonomics (HFE) and have started to create dedicated roles within their organizational structure for HFE practitioners and researchers to work with safety and quality groups to enhance safety, productivity, and overall system efficiencies. This panel brings together HFE personnel from different organizations, who will share their experiences working with clinical partners, in healthcare systems. Specifically, the panelists will lead an interactive discussion with audience members on strategies for changing the safety culture required to achieve the status of a high reliability organization (HRO). The panel will also share methods for demonstrating return on investment for HFE and techniques for successful implementation to continue the long-term integration of HFE into safety and quality improvement projects within healthcare organizations.
Applied Ergonomics
Informal caregivers are an integral part of care delivery for persons with dementia (PwD). Inform... more Informal caregivers are an integral part of care delivery for persons with dementia (PwD). Informal caregivers take part in a wide range of care activities both individually and collaboratively with other caregivers. Caregiving often involves high demands in the face of limited resources, which can lead to stress, burden, and burnout. To support caregivers, we need to conceptualize caregiving activities they perform, and the networks and roles through which they perform work. We performed a directed content analysis on interview data from twenty caregivers and applied a human factors approach to characterize informal caregiving work. Our results revealed 1) nuances in caregiving roles, 2) differences in caregiving networks, and 3) 13 categories of caregiving activities characterized by time commitments; physical, cognitive and socio-behavioral demands; and varying network dependencies. These findings can be applied in future studies to evaluate the needs of caregiving networks and how to better support them.
Journal of Surgical Education
OBJECTIVE With recent changes to graduate medical education, the balance between resident autonom... more OBJECTIVE With recent changes to graduate medical education, the balance between resident autonomy and need for supervision impacts the educational and training experience of residents. The objective of this study was to understand the relationship between the confidence of attendings and residents and their different perspectives of perceived educational experience and autonomy in the operating room (OR). We hypothesized that the attending's confidence in the resident would be an important factor in improving the educational experience and resident's autonomy in the OR. DESIGN Self-reported confidence-rating and operative experience surveys were administered to teams of post-graduate year (PGY 1) through PGY 5 surgical residents and attendings in two temporal sets (Early: Sept-Dec 2015, n = 20; Late: Jan-Apr 2016, n = 22). A second "end-of-year" survey was distributed to residents (n = 9, 37.5% response) and attendings (n = 10, 35% response) asking questions regarding their educational experience and operative experience during the past year. SETTING Large rural teaching hospital. PARTICIPANTS Nineteen general surgery residents (PGY 1 - 5) and 14 general surgery attendings. RESULTS Resident perception of confidence differs from junior to senior residents, and that there was discordance between resident's confidence and skill as perceived by attendings, particularly in senior residents. Results also showed that attending's confidence in residents was positively correlated with attending's perceived educational experience in the OR. Residents and attendings both indicated attending's confidence in residents as an important factor in increasing resident autonomy in the OR, thus the attending's confidence in residents could have a positive impact on resident autonomy and educational experience in the OR. CONCLUSIONS We have demonstrated a relationship between self-confidence for residents and improved confidence from attendings in residents' capabilities. Based on these findings, we would propose identifying methods to expand resident's awareness of surgical situations and develop attending's confidence in residents.
Surgical Endoscopy
BackgroundEye-gaze metrics derived from areas of interest (AOIs) have been suggested to be effect... more BackgroundEye-gaze metrics derived from areas of interest (AOIs) have been suggested to be effective for surgical skill assessment. However, prior research is mostly based on static images and simulated tasks that may not translate to complex and dynamic surgical scenes. Therefore, eye-gaze metrics must advance to account for changes in the location of important information during a surgical procedure.MethodsWe developed a dynamic AOI generation technique based on eye gaze collected from an expert viewing surgery videos. This AOI updated as the gaze of the expert moved with changes in the surgical scene. This technique was evaluated through an experiment recruiting a total of 20 attendings and residents to view 10 videos associated with and another 10 without adverse events.ResultsDwell time percentage (i.e., gaze duration) inside the AOI differentiated video type (U = 13508.5, p < 0.001) between videos with the presence (Mdn = 16.75) versus absence (Mdn = 19.95) of adverse events. This metric also differentiated participant group (U = 14029.5, p < 0.001) between attendings (Mdn = 15.45) and residents (Mdn = 19.80). This indicates that our dynamic AOIs reflecting the expert eye gaze was able to differentiate expertise, and the presence of unexpected adverse events.ConclusionThis dynamic AOI generation technique produced dynamic AOIs for deriving eye-gaze metrics that were sensitive to expertise level and event characteristics.
Current Treatment Options in Pediatrics
Purpose of ReviewHuman Factors Engineering (HFE) has had much success in research initiatives to ... more Purpose of ReviewHuman Factors Engineering (HFE) has had much success in research initiatives to identify socio-technical system barriers to improve patient and employee safety and healthcare quality. However, there have only been a few applications of HFE, in which research is translated into practice, and has been implemented in an organization. This paper presents a systematic review of HFE interventions that have been implemented to improve healthcare quality and patient safety, specific to the pediatric population. This paper also discusses the current status of HFE in healthcare and how the science of HFE can be further applied to improve safety in healthcare delivery processes.Recent FindingsIn the last few years, HFE has been applied in many different areas in healthcare. These areas include EHR design, imaging, medication management, patient experience, and care transitions. The interventions include a combination of cognitive, physical, and macroergonomics principles to improve healthcare delivery for pediatric populations.SummaryThis systematic review identifies 28 peer-reviewed articles that have applied HFE in design, development, and implementation of an intervention to improve safety and/or quality for the pediatric population. The articles employ quantitative, qualitative, or mixed methods to assess the effectiveness, acceptability, and sustainability of the intervention.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Introduction Although an understanding of the patient work system has been increasing in the fiel... more Introduction Although an understanding of the patient work system has been increasing in the field of Ergonomics and Human Factors, the role of informal caregivers (unpaid, nonprofessional caregivers) within the patient work system remains largely unexplored (Holden, Schubert, & Mickelson, 2015; Holden, Valdez, Schubert, Thompson, & Hundt, 2017). Informal caregivers include the family members and friends of persons with dementia (PwD), or anyone else who is unpaid, and a non-professional caregiver for a PWD(Reinhard, Given, Petlick, & Bemis, 2008). Nevertheless, informal caregivers are often unsupported and lack guidance with caregiving activities(Alrashed, 2017; Bossen, Christensen, Grönvall, & Vestergaard, 2013). This study represents a first step to define the work of informal caregivers, identify variations in caregiver involvement across multiple caregivers, and explore the perceptions of the primary caregiver (PC) regarding the care network. Understanding the specific roles an...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Persons with dementia (PwD) are an increasing population that are becoming more dependent on info... more Persons with dementia (PwD) are an increasing population that are becoming more dependent on informal caregivers. Thus, caregiver workload is becoming a national concern due to the amount of patient work associated with caregiving. While we have a rudimentary understanding of caregiving work demands, caregiving capacity is an area that needs further inquiry. In this study, we apply a macroergonomic approach to identify non-cognitive resources employed by caregivers, and contingencies for caregivers’ resource usage. We conducted 30 semi-structured interviews with self-identified primary caregivers of persons with dementia. Using the patient work system model, we conducted content and thematic analyses of interview data to build a conceptual model of caregiving capacity. Our conceptual model includes 6 different resources channels that caregivers may activate. We also identified 3 contingencies of resource usage. This model can serve as a foundation for exploring distribution of careg...