Human factors in healthcare最新文献

{"title":"Inspirational leadership, change implementation, and technology adoption in shaping healthcare service effectiveness: A study at Hasan Sadikin hospital, Bandung","authors":"Karina Ansheila,&nbsp;Anderson Kumenaung,&nbsp;Merinda Herrari Chrisnuartanti Pandowo,&nbsp;Arrazi Bin Hasan Jan,&nbsp;Johan Reineer Tumiwa","doi":"10.1016/j.hfh.2025.100120","DOIUrl":"10.1016/j.hfh.2025.100120","url":null,"abstract":"<div><div>This study examines how Inspirational Leadership Style (ILS) influences Healthcare Service Effectiveness (HSE) at Rumah Sakit Hasan Sadikin Bandung, with Change Process Implementation (CPI) and New Technology Adoption (NTA) as mediating variables. A quantitative approach was employed, collecting survey data from 349 hospital leaders, managers, and staff, analyzed using Structural Equation Modeling (SEM). The results reveal that ILS has both direct and significant indirect effects on HSE, primarily mediated through CPI and secondarily through NTA. CPI emerges as the most influential pathway, underscoring the critical role of structured change management in healthcare transformation. The findings reinforce the strategic importance of leadership development, organizational change readiness, and technological adoption to improve healthcare outcomes. The study contributes to the leadership and health management literature, particularly in the context of emerging economies, and offers practical recommendations for healthcare administrators and policymakers. Limitations include the cross-sectional design and single-institution focus. Future research is encouraged to explore longitudinal effects and additional mediating factors such as employee engagement and digital literacy.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100120"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927000","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}

{"title":"Focus on the experts: Co-designing an augmented reality eye-gaze tracking system with surgical trainees to improve endoscopic instruction","authors":"Jumanh Atoum ,&nbsp;Jinkyung Katie Park ,&nbsp;Mamtaj Akter ,&nbsp;Nicholas Kavoussi ,&nbsp;Pamela Wisniewski ,&nbsp;Jie Ying Wu","doi":"10.1016/j.hfh.2025.100115","DOIUrl":"10.1016/j.hfh.2025.100115","url":null,"abstract":"<div><div>The current apprenticeship model for surgical training requires a high level of supervision, which does not scale well to meet the growing need for more surgeons. Many endoscopic procedures are directly taught in the operating room (OR) while the attending surgeon and trainee operate on patients. The need to prioritize patient care limits the trainees’ opportunities to experiment and receive feedback on their performance. Augmented reality (AR) has the potential to increase efficiency in endoscopic surgical training, but additional research is critical to understanding the needs of surgical trainees to inform the design of AR training systems. Therefore, we worked with 18 surgical trainees to understand the strengths, limitations, and unmet needs of their current training environment and to co-design an AR eye-gaze tracking system based on their preferences. Trainees emphasized the need to practice the 2D to 3D mapping needed to properly familiarize oneself with the anatomy of patients to prepare for real surgery. The trainees felt that an AR-based eye-gaze tracking system would be a useful supplemental training method that would improve their learning in OR cases without detracting from patient care. To tailor the AR system to their needs, they co-designed features to improve their ability to track the attending surgeon’s eye-gaze and to provide a real-time, interactive system. Our results are valuable in shaping the endoscopic training modules by generating user-informed guidelines to design future collaborative AR-based eye-gaze tracking systems.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100115"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760838","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}

{"title":"Tall man lettering as a solution for look-alike sound-alike errors: A systematic literature review","authors":"K Raghav Bhat,&nbsp;Robert S. Gutzwiller","doi":"10.1016/j.hfh.2026.100123","DOIUrl":"10.1016/j.hfh.2026.100123","url":null,"abstract":"<div><div>Medication errors, particularly those involving Look-Alike Sound-Alike (LASA) drugs, are a critical concern in healthcare, often resulting in adverse patient outcomes. Tall Man Lettering (TML) has been proposed as a visual enhancement strategy to mitigate these errors by making drug names more distinguishable. This systematic literature review evaluates the effectiveness of TML in reducing LASA errors and identifies factors contributing to the variability in its effectiveness across different healthcare settings and populations. The review encompasses data from 16 studies, incorporating 25 experiments. The findings reveal mixed results regarding the efficacy of TML, with some studies demonstrating significant improvements, whereas others report no effect or even negative outcomes. Key factors influencing the effectiveness of TML include participant group (healthcare professionals vs. non-professionals), drug familiarity, awareness of TML's purpose, target presence, exposure time, and orthographic similarity. These results suggest that while TML can be beneficial in specific contexts, its universal application as a standalone solution is limited. The review highlights the need for integrating multiple strategies to enhance medication safety and calls for further research to improve the generalizability and real-world applicability of TML interventions.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100123"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978025","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}

{"title":"Linking UI design to training effectiveness, efficiency, and satisfaction in central venous catheterization simulation","authors":"Ava Knaf ,&nbsp;Sanaz Motamedi ,&nbsp;Jason Z. Moore ,&nbsp;Sanjib Adhikary ,&nbsp;Scarlett R. Miller","doi":"10.1016/j.hfh.2025.100118","DOIUrl":"10.1016/j.hfh.2025.100118","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to understand what updates to the user interface (UI) of our medical training simulator, the DHRT+, led to an increase in usability as defined by its three pillars—effectiveness, efficiency, and satisfaction.</div></div><div><h3>Background</h3><div>Medical error is a leading cause of death in the United States. Central venous catheterization (CVC) is a large contributor to this issue with its 15 % complication rate, which is primarily linked to the experience of the physician. Current training methods for CVC are limited by inadequate practice time, the inability for full procedural practice, and the lack of anatomical variety and feedback. To combat these issues, the Dynamic Haptic Robotic Trainer (DHRT+) was developed as a new training alternative.</div></div><div><h3>Methods</h3><div>Our investigation included statistical analysis of the changes in first-year medical residents’ usability of the DHRT+ training. Additional analysis was conducted using a Mask R-CNN algorithm to map gaze fixations on targeted areas of UI improvement.</div></div><div><h3>Results</h3><div>Comparing performances from training bootcamps in 2023 and 2024, findings revealed mixed outcomes: a marginal improvement in perceived usability (SUS), a trend toward faster VOP completion times, and significant changes in gaze behavior reflecting altered user strategies. Effectiveness metrics (failure count and tip-tracking rate) did not show significant improvement. Qualitative feedback highlighted that clearer instructions and real-time feedback were viewed as the most beneficial UI updates.</div></div><div><h3>Conclusion</h3><div>The work of this study contributes to the broader impact of providing a framework for essential UI changes for improving the usability of simulations in healthcare. These results demonstrate how usability principles, such as on-the-spot feedback, improved instructional quality, and intuitive UIs can be used to improve training results and promote patient safety.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100118"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926999","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}

{"title":"Healthcare utilization patterns to inform health system design","authors":"Alexis McGill ,&nbsp;Vahid Salehi ,&nbsp;Chandy Somayaji ,&nbsp;James Ted McDonald ,&nbsp;Kimberley Barker ,&nbsp;Duyen Nguyen","doi":"10.1016/j.hfh.2026.100143","DOIUrl":"10.1016/j.hfh.2026.100143","url":null,"abstract":"<div><h3>Background</h3><div>As with many other parts of Canada, New Brunswick (NB) has experienced rapid demographic growth driven by immigration, with many newcomers arriving from regions with healthcare systems that differ significantly from Canada’s. Understanding healthcare utilization patterns among immigrant populations is important not only for service planning but also for assessing how healthcare system design supports access, navigation, and use within an increasingly diverse population.</div></div><div><h3>Purpose</h3><div>This study examines and compares healthcare utilization patterns among newcomers (defined to be non-Canadian-born, residing in NB &lt;5 years), longer-term immigrants (non-Canadian-born, ≥5 years), and non-immigrants (Canadian-born or interprovincial migrants), interpreting observed differences as indicators of how different user groups access and navigate a complex healthcare socio-technical system.</div></div><div><h3>Methods</h3><div>A retrospective cohort study (2017–2021) was conducted using linked Provincial administrative and Federal immigration data accessed through the New Brunswick Institute for Research, Data, and Training. Age-standardized utilization rates per 100 individuals were calculated for four domains: walk-in clinic visits, general practitioner (GP) visits, emergency department (ED) visits, and hospital admissions. Adjusted logistic regression models controlled for age, sex, health zone, socioeconomic status, and length of residence.</div></div><div><h3>Results</h3><div>Newcomers demonstrated higher use of walk-in clinics and lower use of GP and ED than non-immigrants, particularly in their early years of residence. Over time, utilization patterns shifted toward greater engagement with GP services and reduced reliance on episodic care services, suggesting gradual integration into primary care pathways. Refugees consistently demonstrated the highest ED visit rates, while international students and temporary foreign workers (TFWs) exhibited the lowest overall engagement, indicating potential underutilization and/or unmet needs.</div></div><div><h3>Conclusions</h3><div>Healthcare utilization patterns in NB varied by immigration status and duration of residence, reflecting differences in how population groups interact with available care pathways. The observed reliance of episodic care among some newcomer groups suggests misalignment between healthcare system design and user needs during early settlement. Addressing these patterns requires culturally responsive, equity-oriented care models, and system-level design interventions that better align healthcare structures, access pathways, and organizational workflows with the needs of diverse user groups.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100143"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184145","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}

{"title":"Using the Delphi technique and critical decisions method to derive nursing student training requirements for sepsis detection in adult patients","authors":"Pratima Saravanan ,&nbsp;Stephen L. Jones ,&nbsp;Cindy Weston ,&nbsp;Tammy McGarity ,&nbsp;Angela Mulcahy ,&nbsp;Sara Melendez ,&nbsp;Farzan Sasangohar","doi":"10.1016/j.hfh.2025.100122","DOIUrl":"10.1016/j.hfh.2025.100122","url":null,"abstract":"<div><div>At least 1.7 million adults in the U.S. develop sepsis each year, and there exists no widespread training programs for early recognition of infections for sepsis risk reduction. To address this gap, this study focused on triangulating the training and educational requirements to develop simulation-based tools for a novel sepsis curriculum for nursing students. A concurrent two-phase mixed-methods triangulation study was conducted. In phase 1, critical decisions method (CDM) interviews were used to model key sepsis recognition decisions and processes which informed realistic scenarios for simulation training. In phase 2, a Delphi study was conducted with sepsis leaders to systematically gain consensus on training requirements, specifically the mode of training and content of a curriculum for early sepsis recognition.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100122"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884968","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}

{"title":"Evaluating accessibility in telehealth platforms using heuristic review: A case study of the pathways application","authors":"Amro Khasawneh ,&nbsp;Philip Gallagher ,&nbsp;James Jarrett ,&nbsp;Emily Jacobson","doi":"10.1016/j.hfh.2025.100119","DOIUrl":"10.1016/j.hfh.2025.100119","url":null,"abstract":"<div><h3>Background</h3><div>As telehealth platforms become essential in healthcare delivery, ensuring accessibility for individuals with disabilities is critical. However, existing digital accessibility standards such as WCAG 2.0 and Section 508 are often difficult to apply and insufficiently enforced, particularly in real-world healthcare applications.</div></div><div><h3>Objective</h3><div>This study evaluates the effectiveness of a newly developed set of ADA-aligned accessibility heuristics by applying them to the Pathways telehealth platform to identify usability barriers for people with disabilities.</div></div><div><h3>Methods</h3><div>A heuristic evaluation methodology was employed using five trained subject matter experts (SMEs) in human factors and accessibility. SMEs independently evaluated the Pathways platform using custom heuristics organized under the POUR framework (POUR stands for Perceivable, Operable, Understandable, and Robust) (W3C, 2025). Each SME assessed both patient and provider interfaces, using screen readers and varied hardware/software configurations. Accessibility issues were rated by severity and analyzed qualitatively.</div></div><div><h3>Results</h3><div>The evaluation identified 44 unique accessibility issues: 38% rated as Critical, 31% as Major, 22% as Minor, and 6% as Minimal. Key barriers included unlabeled buttons, inaccessible navigation menus, improperly tagged content, and lack of alternative formats for audio and visual information. Most issues impaired screen reader usability and keyboard navigation.</div></div><div><h3>Conclusions</h3><div>The findings confirm that heuristic-based evaluations are effective for identifying critical accessibility gaps in telehealth platforms. The results offer actionable recommendations and highlight the need for inclusive design practices in digital healthcare tools. These heuristics can serve as a practical and scalable model for improving ADA compliance across telemedicine systems.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100119"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841675","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}

{"title":"CANCER Mnemonic: A structured approach to oncologic emergencies in acute care","authors":"Gustavo Guerra Jacob ,&nbsp;Maria Helena Cruz Rangel Silva ,&nbsp;Fabricio Dias","doi":"10.1016/j.hfh.2025.100121","DOIUrl":"10.1016/j.hfh.2025.100121","url":null,"abstract":"<div><div>The global rise in cancer cases is creating unprecedented demands on emergency departments (EDs), with approximately 75% of cancer patients visiting EDs during their final year of life. Despite the frequency of these encounters, many emergency professionals report feeling unprepared to manage complex oncological emergencies. To address this educational gap, we developed the \"CANCER\" mnemonic (Confirm cancer diagnosis, Assess advanced directives, identify Necessities, Communicate with care team, Emergency management, Reassess and revise) as part of the Acute Oncology Life Support® certification program. This cognitive aid was designed through extensive literature review and multidisciplinary expert consultation to guide systematic assessment and management of oncologic emergencies. The mnemonic provides a structured framework for emergency professionals to confirm cancer status, verify advance directives, review current treatments, coordinate with oncology teams, implement evidence-based interventions, and continuously reassess clinical responses. Implementation strategies include EHR integration, standardized documentation, and simulation-based training. While preliminary feedback suggests improved clinical decision-making and provider confidence, multi-center validation studies are needed to establish its impact on patient outcomes, provider performance, and resource utilization. The CANCER mnemonic represents a promising approach to standardizing and optimizing emergency care for the growing population of cancer patients.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"9 ","pages":"Article 100121"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926995","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}

{"title":"A case study approach to understand Black adults’ engagement with a smartwatch","authors":"Maurita T. Harris,&nbsp;Wendy A. Rogers","doi":"10.1016/j.hfh.2025.100114","DOIUrl":"10.1016/j.hfh.2025.100114","url":null,"abstract":"<div><div>As Black adults age, addressing potential hindrances to healthy aging becomes increasingly important—especially given that Black middle-aged adults often develop chronic conditions and multimorbidity earlier than their White counterparts. Smartwatches can collect vital health metrics (e.g., heart rate, sleep, oxygen saturation) and represent a promising technology for promoting proactive health self-management. To develop equitable and effective smartwatches, involving diverse populations to consider their needs and experiences is critical. We conducted a case study with six Black adults (50+) to investigate their engagement with a smartwatch for health self-monitoring over one month. Data were gathered through surveys and questionnaires to capture rich, real-time insights into participants' evolving behaviors, perceptions, and challenges. Participants noted their smartwatch was a potentially empowering tool that offered feedback on health indicators (e.g., heart rate and steps). The ability to access this readily available information motivated some participants to establish goals and consider lifestyle adjustments. Participants noted facilitators and barriers that influenced their sustained engagement with the smartwatch. Facilitators included perceived usefulness, relevance to personal health goals, and the prospect of integrating the device into daily routines. At the same time, participants expressed uncertainty about interpreting complex data and the absence of straightforward instructions as critical barriers to long-term adoption. Our findings guide the development of user-centered wearable activity monitors (WAMs) and supportive infrastructures that effectively help Black older adults manage chronic conditions.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"8 ","pages":"Article 100114"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578823","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}

{"title":"Designing, prototyping, and evaluating an assistive device for lower limb muscle stretching: With the participatory approach","authors":"Ali Akbar Asil ,&nbsp;Ali E Oskouei ,&nbsp;Neda Gilani ,&nbsp;Melika Khabbazi ,&nbsp;Jalil Nazari","doi":"10.1016/j.hfh.2025.100109","DOIUrl":"10.1016/j.hfh.2025.100109","url":null,"abstract":"<div><h3>Introduction</h3><div>Stretching techniques are among the most widely used rehabilitation techniques in various cases. These techniques are primarily performed manually by physical and occupational therapists. From an ergonomics perspective, manual stretching has significant potential for developing work-related musculoskeletal disorders among therapists because of therapists’ considerable force exertion in static-awkward postures. This study aims to design, prototype, and evaluate an assistive stretching device through a participatory approach.</div></div><div><h3>Method</h3><div>In several interviews with therapists, the features of the stretching device were determined. Sketching, designing, and modeling were done, and the therapists’ feedback is applied at every step. Then an assistive device was prototyped by considering anthropometric dimensions. The device was tested by 32 healthy undergraduate and graduate physical therapists or occupational therapists.</div></div><div><h3>Results</h3><div>For evaluating the device's ability for correct stretching, joint angle changes during the application of muscle stretch were considered. The device was able to keep changes under 10 degrees in 222 of 224 device-assisted stretches. The total score of the System Usability Scale (SUS) is 87.42±7.08.</div></div><div><h3>Conclusion</h3><div>This designed assistive device for performing stretching techniques on lower limb heavy muscles (hamstrings, calves, iliopsoas, quadriceps, hip adductors, hip abductors, and gluteus) could be a step towards healthier therapists and high-quality treatment by enabling correct stretching with less effort from therapists. It seems that by using these study experiments and continuing to redesign assistive devices in the rehabilitation field, we can achieve high-quality rehabilitation services and healthy medical staff.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"8 ","pages":"Article 100109"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772697","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}