Human factors in healthcare最新文献

{"title":"Understanding older adults’ motivations to use digital health portals","authors":"Mimi Trinh,&nbsp;Varitnan Hattakitjamroen,&nbsp;Wendy A. Rogers","doi":"10.1016/j.hfh.2024.100079","DOIUrl":"10.1016/j.hfh.2024.100079","url":null,"abstract":"<div><h3>Objective</h3><p>To understand how older adults perceive digital health portals (DHPs), what motivates them to use them, and how their experience can be improved.</p></div><div><h3>Background</h3><p>The number of people over age 60 will continue to increase over the following decades. Many older adults have chronic health conditions such as high blood pressure or diabetes. Digital health technology, specifically DHPs, could be helpful in wellness management, healthcare provider communication, and health record management.</p></div><div><h3>Method</h3><p>We interviewed 26 older adults aged 60–85 who logged into their DHP at least twice a year to learn more about their usage and motivations to adopt DHPs. We integrated the Self Determination Theory (SDT) and the Unified Theory of Acceptance of Use of Technology (UTAUT) model to assess factors that were intrinsic motivators and what facilitated the use of DHPs. We coded the transcribed data into these categories to evaluate the factors that were reportedly important to the older adults’ use of their health portal.</p></div><div><h3>Results</h3><p>All the older adults shared that they were willing to communicate with their healthcare provider, and 25 of the 26 reported that their DHP supported their healthcare needs. The older adults were primarily influenced by family members or healthcare providers to support their wellness. Our integration of the SDT theory and UTAUT model provides insights into motivational factors that guide use of DHPs.</p></div><div><h3>Conclusion</h3><p>Social support from friends and family supported general usage and provided additional guidance for DHP features. The findings of this study provide recommendations on how to redesign navigation within future health portals, how older adults are encouraged to use their DHP, and how they are provided support when using their DHP.</p></div><div><h3>Précis</h3><p>How do we help older adults with health self-management? Digital health portals, including features such as electronic health records and clinician communication have potential but are underutilized. Understanding motivational influences can guide design and support for digital health portals.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"6 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000162/pdfft?md5=5cb2ce0aaf83237954faf5567b6c8791&pid=1-s2.0-S2772501424000162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the occupational exposures within homes for home healthcare workers in the United Kingdom","authors":"A.C. Dondi ,&nbsp;R. Bellacov ,&nbsp;M. Fray ,&nbsp;K.G. Davis","doi":"10.1016/j.hfh.2024.100080","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100080","url":null,"abstract":"<div><p>Many of the tasks being conducted by home healthcare workers are associated with significant complex demands. Each home is a unique work environment with potentially different exposures. The purpose of this study was to investigate the plethora of exposures for home healthcare workers in the United Kingdom. The study was a cross-sectional study that utilized a trained supervisor to complete the direct observation of the healthcare worker (nursing aide and nurse). Environmental hazards that were captured included mold/mildew (8.7%) and dogs (14.5%), and secondhand smoking (15.9% with smell in home and 8.7% with active smoking). Verbal abuse was prominent for nurse aides (31% experiencing it). Ergonomic hazards were observed through various tasks such as repositioning in bed (34.8%), transfer from bed to chair (30.4%), transfer from bed to chair (26.1%), and transfer from chair to chair (26.1%) and particularly for nursing aides. The results of the current observations indicated that home healthcare workers faced a multitude of exposures that could lead to injuries. This provides a rigid platform for occupational safety and ergonomics specialists to appreciate the occupational exposures and challenges that home health care workers face in the unique home care environment and proactively identify mitigation measures of the respective occupational hazards.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"6 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000174/pdfft?md5=b4cbf68c6b7f3fa2cf8c229ed9264a9d&pid=1-s2.0-S2772501424000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team adaptive capacity and adaptation in dynamic environments: A scoping review of the literature","authors":"Natalie Sanford ,&nbsp;Olivia Lounsbury ,&nbsp;Gabriel Reedy ,&nbsp;Dame Anne Marie Rafferty ,&nbsp;Janet E. Anderson","doi":"10.1016/j.hfh.2024.100089","DOIUrl":"10.1016/j.hfh.2024.100089","url":null,"abstract":"<div><div>Healthcare systems rely on the expertise, ingenuity, and resilience of healthcare teams to maintain safe and high-quality care in complex, variable, and resource-constrained environments. Research has suggested that successful team adaptation prevents patient harm, optimises efficiency, and keeps healthcare systems running. Team adaptation is a central concept in both teamworking and organisational resilience theory, but team adaptation and its associated concepts, specifically team adaptive capacity, remain underspecified, ill-defined, and poorly understood in healthcare. Other high-risk industries, such as aviation, military, and nuclear power, may have a more extensive evidence base that can inform conceptualisations in healthcare and beyond. This scoping review synthesizes the cross-disciplinary literature on team adaptation, proposes a new definition for team adaptive capacity, and develops a model for understanding team adaptation, its outcomes, and antecedents: the team adaptive cycle.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"6 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying emergency physicians’ strategies for mitigating workload transfers during end of shift patient handoffs – A qualitative analysis","authors":"Steven Foster ,&nbsp;Sudeep Hegde ,&nbsp;Ronald Pirrallo ,&nbsp;Vishnu Girishan Prabhu ,&nbsp;Kevin Taaffe ,&nbsp;Michael Ramsay ,&nbsp;William Jackson","doi":"10.1016/j.hfh.2024.100088","DOIUrl":"10.1016/j.hfh.2024.100088","url":null,"abstract":"<div><div>In hospital emergency departments (EDs), emergency physicians (EPs) regularly handoff patients to one another at shift changes. While previous studies have focused on standardizing communication practices during handoffs, these efforts do not address how handoffs contribute to transfers of excess workload for EPs, nor the strategies utilized by EPs to mitigate such workload transfers. Forty-four observations were conducted at a large referral hospital and Level 1 trauma center. Observations of EPs’ workstations were conducted during 4-hour intervals centered on end of shift patient handoffs. Following observations, interviews were conducted with 12 attending EPs pertaining to the structuring of information during handoffs, strategies used to prepare for handoffs, interpersonal and environmental considerations that may affect handoffs, and any workflow adaptations that occur due to such considerations. Interview data were analyzed using qualitative coding and subsequent thematic analysis. Findings from this study revealed four thematic categories: traditional sign-out workflows, importance of the state of patient disposition, adaptive strategies for mitigating workload transfers, and EP motivations and obligations regarding sign-outs. Ultimately, the adaptive workflows and mitigation strategies utilized by EPs during end of shift patient handoffs demonstrate their ability to adapt and effectively reduce the amount of cognitive workload transferred during handoffs.</div></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"6 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the complexity of a stroke care system through functional modelling and analysis","authors":"Vahid Salehi ,&nbsp;Brian Veitch ,&nbsp;Doug Smith ,&nbsp;Jason McCarthy","doi":"10.1016/j.hfh.2024.100084","DOIUrl":"10.1016/j.hfh.2024.100084","url":null,"abstract":"<div><p>Stroke is a leading cause of disability and death worldwide. Care of stroke patients is both complex and resource-intensive. Understanding this complexity is crucial for improving healthcare delivery. This study aimed to model and analyze the complexity of a stroke care system. Data were gathered through document review and interviews with 17 healthcare professionals in a city in eastern Canada. The Functional Resonance Analysis Method (FRAM) was employed to model the stroke care system, identify the sources of variability, and propose solutions to improve the stroke care system. The study identified 73 interconnected functions that constitute a functional model of the stroke care system spanning from preadmission to discharge. The functional model illustrates how stroke patients enter the system, receive treatment, and transition after discharge. The results of this study revealed that 1) staffing ratio, 2) health staff training, 3) scheduling, 4) documentation, and 5) equipment and space are significant sources of variability in the stroke care system. These findings enable healthcare professionals to focus on managing significant changes and enhancing their ability to navigate the complexity of the stroke care effectively.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"6 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000204/pdfft?md5=e2e65a313c004384b60e840155c32d12&pid=1-s2.0-S2772501424000204-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motives and fluent interaction in clinical documentation: An experience-based design for a documentation tool in anesthesiology","authors":"Tobias Grundgeiger ,&nbsp;Christian Juranz ,&nbsp;Jörn Hurtienne ,&nbsp;Oliver Happel","doi":"10.1016/j.hfh.2024.100071","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100071","url":null,"abstract":"<div><p>Documentation in anesthesiology is important but documentation quality is poor and frequently delayed. Using documentation in anesthesiology, we suggest an experience-based design approach that considers users’ motives and work practices in the design of technology to provide users with the experience of achieving valued motives (activity theory) and a fluent interaction with the environment (embodiment). We conducted an ethnographic study to identify documentation work practices, the anesthesiologists’ motives for documenting, and assess documentation quality. Based on the data and with the theoretical premises of activity theory and embodiment in mind, we designed the functions and interaction of a speech-based documentation tool. Using the Wizard of Oz method in a simulated induction of general anesthesia, we showed that the tool enabled fluent interaction, addressed a motive that anesthesiologists valued, and increased the documentation quality. We demonstrated that an experience-based design can enhance documentation quality and has the potential to contribute to safety and efficiency in safety-critical domains and provide grounds for future decision support systems.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000083/pdfft?md5=0db601f7a5dbd2fd80553bbe49d2c720&pid=1-s2.0-S2772501424000083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From vision to reality: How human factors can inform the design of cardiac diagnostic services in community settings","authors":"M. Sujan ,&nbsp;E Crumpton ,&nbsp;V. Finch ,&nbsp;J Combes","doi":"10.1016/j.hfh.2024.100075","DOIUrl":"10.1016/j.hfh.2024.100075","url":null,"abstract":"<div><h3>Introduction</h3><p>Expanding diagnostic capacity in healthcare systems requires new service delivery models like Community Diagnostic Centres (CDCs). Designing effective diagnostic services in the community requires attention to the practical realities of the work system in addition to the clinical vision.</p></div><div><h3>Methods</h3><p>This study applied a human factors approach through the Systems Engineering Initiative for Patient Safety (SEIPS) model to inform the design of community cardiac diagnostic services, focusing on workforce design and the potential role of cardiac physiologists. The study setting was a cardiology department at a community hospital. Data were collected through observations, interviews and focus groups. Data were analysed using SEIPS and Thematic Analysis.</p></div><div><h3>Results</h3><p>The analysis revealed three overarching design considerations: (1) Promoting professional growth and autonomy for the cardiac workforce in the community. (2) Focusing on the needs of patients in the community, including accessibility and communication. (3) Facilitating communication across organisational boundaries, particularly between CDCs and General Practitioners (GPs).</p></div><div><h3>Conclusion</h3><p>Human factors offers valuable insights to bridge the gap between clinical vision and practical implementation of CDCs. Addressing identified design considerations can ensure effective workforce models, patient-centred care, and seamless collaboration within the healthcare system.</p></div><div><h3>Implications for practice</h3><p>Integrating human factors expertise into community diagnostic services design and implementation teams can contribute to patient-centred services and effective workflows. This requires access to specialised human factors expertise. Providers of diagnostic services could consider embedding human factors expertise into their settings and tap into existing educational human factors frameworks.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000125/pdfft?md5=476a086ea30e94e9c619ed0ff04eb127&pid=1-s2.0-S2772501424000125-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-efficacy and its miscalibration in cricothyroidotomy training","authors":"Dr. Kent C. Etherton,&nbsp;Dr. James P. Bliss,&nbsp;Ms. Jennifer Winner","doi":"10.1016/j.hfh.2024.100066","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100066","url":null,"abstract":"<div><h3>Introduction</h3><p>Often, trainers use self-assessed competency, or self-efficacy, as a substitute for objective metrics of ability. However, self-efficacy is subject to several cognitive biases like the Dunning-Kruger effect: the tendency for those unskilled at a task to be unaware of their own incompetence (Kruger &amp; Dunning, 1999). We investigated factors that affect self-efficacy and its calibration with performance. This included examining the role of task knowledge when estimating self-efficacy, using recently proposed analyses to assess the Dunning-Kruger effect (Gignac &amp; Zajenkowski, 2020), and examining how indices of such effects may be partially affected by the simulator one trains with.</p></div><div><h3>Methods</h3><p>We recruited participants (<em>N</em> = 52) from the local population of a Midwest area in the United States. Using didactic training, a subject matter expert trained participants over a series of trials in a laboratory setting to perform cricothyroidotomy.</p></div><div><h3>Results</h3><p>Results indicated the presence of one, but not both indices of Dunning-Kruger effects (i.e., heteroscedasticity, but not quadratic regression), unique variance in self-efficacy accounted for by task knowledge after controlling for performance, and that the Dunning-Kruger indices were affected by one's training simulator.</p></div><div><h3>Conclusions</h3><p>The current study raised issues relating to the nature of Dunning-Kruger analyses, the importance of task knowledge, and how the analyses conducted in the current study can provide trainers and researchers valuable insights to medical trainees. In sum, our results highlight the value in assessing Dunning-Kruger effects in medical training contexts and provide directions for future research on self-efficacy and its calibration with performance.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000034/pdfft?md5=28334f150fd7c4312b5be62a54ed1f1c&pid=1-s2.0-S2772501424000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An academician's approach to the application of human factors standards: A case study on a liver support system","authors":"Jeremy Opie ,&nbsp;Euan McCann ,&nbsp;Harris Qureshi ,&nbsp;Thomas Brookshaw ,&nbsp;Eloy Erro ,&nbsp;Clare Selden ,&nbsp;Ann Blandford","doi":"10.1016/j.hfh.2024.100070","DOIUrl":"10.1016/j.hfh.2024.100070","url":null,"abstract":"<div><p>Until recently, academia typically did not engage with the development of medical technology but instead developed techniques, processes, and lab-evaluated studies that were picked up by industry. With the introduction of rapid prototyping and access to information via the internet, more and more medical technology is being developed within academia from conception to product. However, academia still suffers from siloed research groups, access to partial knowledge, and anticipating, at the outset, the requirements of a final product necessary to engage all the required multidisciplinary input. Support for the design and development of the technology can often be provided by other academic departments; however, the current environment of isolated research, often due to funding remit restrictions and limited resources, limits this. In this paper, we highlight lessons learnt within academia about using regulatory standards within a multidisciplinary research project to assess the usability of a novel medical device; specifically, the current guidance is not sufficient for new practitioners to apply regulatory processes straightforwardly. We report on the assessment of a novel medical device being evaluated to regulatory standards, using the system under ‘<em>normal use</em>’, and discuss how using ecological validity as a guide can help ensure that the device is effective, efficient, and most importantly safe.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000071/pdfft?md5=fcd64dee1692dedc5f1e8dd75874059d&pid=1-s2.0-S2772501424000071-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepping into the virtual realm: Examining the utility of non-immersive VR on medical residents' self-efficacy, performance, and satisfaction","authors":"Jessica M. Gonzalez-Vargas ,&nbsp;Elizabeth Sinz ,&nbsp;Jason Z. Moore ,&nbsp;Scarlett R. Miller","doi":"10.1016/j.hfh.2024.100072","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100072","url":null,"abstract":"<div><p>Central Venous Catheterization (CVC) is conducted in more than 5 million patients annually in the United States. Currently, CVC theoretical knowledge is typically taught with didactic lectures with minimal assessment of knowledge before simulation training and clinical environment. To assess CVC theoretical knowledge, virtual reality (VR) can develop residents’ surgical skills and can provide feedback on performance. While all types of VR can be used to assess improvements in residents’ knowledge prior to simulation training, few studies have compared the impact of non-immersive VR on improving resident knowledge. The current study was developed to identify the utility of a non-immersive CathSim VR on improvements in resident CVC theoretical knowledge, self-efficacy, and satisfaction when compared to a traditional multiple-choice assessment This was completed through an empirical investigation with 34 medical residents. The results showed that when compared to a traditional multiple-choice assessment, the non-immersive CathSim VR assessment led to improvements in self-efficacy and potentially better learning experience. Meanwhile, results also showed that there were no differences in assessment score, number of attempts, and overall satisfaction. Thus, we can conclude that non-immersive VR has the potential to be more effective than traditional multiple-choice test in improving self-efficacy and is as effective for residents’ assessment score, number of attempts, and overall satisfaction.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000095/pdfft?md5=80c5107010fda4c0d175f58464dc8563&pid=1-s2.0-S2772501424000095-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140347235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}