Human factors in healthcare最新文献

{"title":"Prevalence, taxonomy, and outcomes of inpatient imaging incidental findings","authors":"Preetha Nair ,&nbsp;Niraj Madhani ,&nbsp;Bryan Block ,&nbsp;Lindsay Ripley ,&nbsp;Maryam Warsi ,&nbsp;Anita Hegde ,&nbsp;Eugene S. Chu","doi":"10.1016/j.hfh.2023.100037","DOIUrl":"10.1016/j.hfh.2023.100037","url":null,"abstract":"<div><h3>Objective</h3><p>Incidental findings, including masses, anatomic abnormalities, medical conditions, and foreign bodies, are an increasingly common medical phenomenon. We sought to categorize and determine the risk and prevalence of incidental findings in an inpatient setting as well as the appropriateness of follow-up and clinical outcomes.</p></div><div><h3>Methods</h3><p>We performed a cross sectional study of 210 patients admitted to the hospital medicine service between January 1, 2018, and May 31, 2018. Incidental findings were identified and categorized into anatomic abnormalities, masses, medical conditions and foreign bodies. They were assigned harm scores ranging from 1 to 5 with 1 representing potential for catastrophic harm and 5 representing no potential for harm. Appropriate follow-up and adverse events were determined.</p></div><div><h3>Results</h3><p>We identified 235 incidental findings of which 179 (76.2%) had a harm score of 4 (20.0%) or 5 (56.2%). 43 (18.3%) incidental findings had a harm score of 3. None had a harm score of 1 and 13 (5.5%) had a harm score of 2. 79 (33.6%) were anatomic abnormalities, 40 (17%) were masses, 115 (48.9%) were medical conditions, and 1 (0.4%) was a foreign body. Of the 13 incidental findings with a harm score 2, only 2 (15.4%) were addressed during the hospital stay or within 2 months of hospitalization. There were 29 studies with a radiologist's recommendation for follow-up, 41.3% of the recommended follow-ups were completed in the suggested timeframe. Five (2.1%) of the incidental findings without recommended follow-up progressed. None resulted in deaths.</p></div><div><h3>Conclusions</h3><p>Incidental findings are common among hospitalized patients undergoing imaging studies. Most incidental findings are low-risk and are not specifically addressed in the discharge plan or in follow-up. The high prevalence of low-risk incidental findings may contribute to limited adverse clinical outcomes for the rare, high-risk incidental findings.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48166821","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":"Generating creative solutions to address over-the-counter medication safety in older adults using invisible design","authors":"Ashley O Morris ,&nbsp;Maria E Berbakov ,&nbsp;Aaron M Gilson ,&nbsp;Corey A Lester ,&nbsp;Jamie A Stone ,&nbsp;Michelle A Chui","doi":"10.1016/j.hfh.2023.100034","DOIUrl":"10.1016/j.hfh.2023.100034","url":null,"abstract":"<div><h3>Background</h3><p>Participatory design (PD) is commonly used in human factors to develop and design interventions. Invisible design is a useful tool that can be applied in PD for generating intervention ideas with stakeholders, to solve complex problems without requiring end-users to be able to entirely articulate the “problem.” This study utilized invisible design to build a community-pharmacy intervention for older adults, to improve their over-the-counter medication safety. In the U.S., half of adults ages 65 and above (older adults) use over-the-counter medications (OTCs) unsafely. The purpose of this paper is to describe invisible design and highlight its value when designing system-level interventions.</p></div><div><h3>Methods</h3><p>Invisible design is a scenario-based approach that allows participants to brainstorm solutions to an unseen problem. In this study, invisible design was used to elicit stakeholder feedback to inform a new pharmacy-based intervention designed to reduce OTC medication misuse. A series of video scenarios were developed to help stakeholders imagine solutions to the identified patient safety gaps in older adult medication selection and pharmacy interactions.</p></div><div><h3>Results</h3><p>Stakeholders used the invisible design videos to imagine 52 solutions on how to address OTC medication safety in pharmacies. The solutions were grouped into three goals: (1) Facilitating Patient Autonomy, (2) Facilitating a Pharmacist-Patient Encounter, and (3) Facilitating Informed Pharmacist Recommendations. Many of these generated solutions were adopted as features of a pharmacy-based intervention, the Senior Section.</p></div><div><h3>Conclusions</h3><p>Invisible design successfully led to the brainstorming of innovative solutions by key stakeholders and could be used to develop future interventions outside of the field of pharmacy.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49119124","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":"Stepping Beyond Efficacy: Understanding the User Experience of Wearables for Children with Idiopathic Toe Walking in the Natural Setting","authors":"LouAnne Boyd ,&nbsp;Rahul Soangra ,&nbsp;Lara Mukhar ,&nbsp;Rachel Kling ,&nbsp;Marybeth Grant Beuttler","doi":"10.1016/j.hfh.2023.100044","DOIUrl":"10.1016/j.hfh.2023.100044","url":null,"abstract":"<div><p>Idiopathic Toe Walking is an atypical gait pattern that results in limited mobility, pain, and higher risk of falling. Current therapeutic interventions lack the ability to be implemented outside the clinic or lab. Beyond this, it is unclear if gait analysis and real-time feedback is technologically feasible to attain within a user's natural environment. In our research we aimed to understand the child and parent participants’ experience of an innovative wearable system. We surveyed children and parents after the deployment of a functional prototype with real time vibrotactile feedback for awareness of toe walking via a shoe insert paired with a smartphone for visual feedback. Findings revealed insights into design considerations for wearable technologies for children. Factors such as comfort of using the system (physically and psychologically), child's perception and response to the vibrotactile feedback, and children and parents’ perception of reduced fall risk, pain, and stigma are discussed.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46322453","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":"Machine learning to operationalize team cognition: A case study of patient handoffs","authors":"Emma Mayes ,&nbsp;Jonathan A. Gehlbach ,&nbsp;Paul M. Jeziorczak ,&nbsp;Abigail R. Wooldridge","doi":"10.1016/j.hfh.2023.100036","DOIUrl":"10.1016/j.hfh.2023.100036","url":null,"abstract":"<div><p>Pediatric care transitions are important to patient safety, and improved methods to provide feedback about care transitions may lead to improvement. We conducted a secondary analysis of five simulations of the handoff of a pediatric trauma patient from the operating room (OR) to the pediatric intensive care unit (PICU) at a high-fidelity simulation center in the Midwestern United States using practicing clinicians as participants. By synthesizing literature with a qualitative content analysis of the simulation recordings, we identified communication content for these transitions: patient information, anesthesia information, surgical information, nursing information, equipment and technology transfer, patient transfer, professional environment, and simulation. We then used the five simulations to demonstrate use of natural language processing (NLP) models to classify communication content and team cognition behaviors, which could automate real-time evaluation of handoffs. We coded the communication content and behavior of each utterance of the simulations to test and train six support vector machine (SVM) models. Our most frequent communication content codes on average were anesthesia information (19.6 occurrences) followed by surgical information (17.6 occurrences). We found that a SVM model utilizing K-fold stratification with hyperparameter sensitivity analysis best classified communication content and behaviors, with accuracy scores of 74.19% and 54.84%, respectively. We believe our model could be improved through training with a larger dataset from real-life handoffs. Our communication content codes are organized according to what role is likely to provide that information, but handoff protocols must be explicitly team-based to allow team members to share information regardless of role.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49171663","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":"Maintaining sleep while improving overnight mobility and comfort with a novel lower limb external mechanical compression system","authors":"Kyle A. Kainec ,&nbsp;Rebecca M.C. Spencer ,&nbsp;Ellen Benjamin ,&nbsp;Mary Emma Searles ,&nbsp;Karen K. Giuliano","doi":"10.1016/j.hfh.2023.100043","DOIUrl":"10.1016/j.hfh.2023.100043","url":null,"abstract":"<div><h3>Background</h3><p>Venous thromboembolism is prevalent, associated with a high degree of morbidity and mortality, and largely preventable. External mechanical compression is a standard of care for prevention, but compliance with traditional external mechanical compression devices is low due to patient reported issues with comfort, mobility, usability, noise, and sleep disturbances. The purpose of this study was to compare user-rated comfort, mobility, usability, noise, perceived sleep disturbance, and objective sleep disturbance for a novel external lower limb mechanical compression device as compared to a standard sequential compression device.</p></div><div><h3>Method</h3><p>Using a 2-day counterbalanced, within-subject repeated-measures design, 16 participants wore two mechanical compression devices, the commonly-used Kendall SCD Express 9525 (SCD) and the novel Recovery Force Movement and Compressions Device (RF-MAC) for 1 night each in their home while sleep was recorded with polysomnography. For each device, participants also completed questionnaires to assess usability, mobility, perceived noise disturbance, and perceived sleep disturbance.</p></div><div><h3>Results</h3><p>The novel RF-MAC device was significantly more comfortable and less noisy than the Kendall SCD. There was marginal evidence that participants sleep longer when wearing the RF-MAC compared to the SCD. User-rated usability, perceived sleep disturbance, and other objective sleep disturbance measures did not differ significantly between the two devices.</p></div><div><h3>Conclusion</h3><p>Patients and clinicians should consider the impact of external mechanical compression devices on user comfort and sleep to improve patient compliance.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49656199","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":"Improving medical device usability by reducing complexity using a novel predictive models-based user interface assessment tool","authors":"Mikaylah Gross ,&nbsp;Courtney Roberts ,&nbsp;Kaitlin Stinson ,&nbsp;Stephanie Wiltman","doi":"10.1016/j.hfh.2023.100041","DOIUrl":"10.1016/j.hfh.2023.100041","url":null,"abstract":"<div><p>This project seeks to improve medical device usability through the development of a novel assessment tool generated in Microsoft Excel to predict and analyze the time and mental effort required for various operators when using medical device hardware and smartphone mobile application dyads. This assessment tool uses operators previously validated in FLM and MTM-1 predictive models for other applications to analyze the perceptual, cognitive, and action-based steps associated with use of such device-application dyads (Karger &amp; Bayha, 1987; Lee et al., 2015). By using this tool, we can identify opportunities to focus user interface design and usability research efforts to minimize complexity before users take it upon themselves to do so, ultimately creating safer and more effective products for patients. The objective of the analysis conducted with the user interface (UI) assessment tool outlined below was to demonstrate a proof of concept that can be validated with future research.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44183206","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":"How affordances and social norms shape the discussion of harmful social media challenges on reddit","authors":"Jinkyung Park ,&nbsp;Irina Lediaeva ,&nbsp;Maria Lopez ,&nbsp;Amy Godfrey ,&nbsp;Kapil Chalil Madathil ,&nbsp;Heidi Zinzow ,&nbsp;Pamela Wisniewski","doi":"10.1016/j.hfh.2023.100042","DOIUrl":"10.1016/j.hfh.2023.100042","url":null,"abstract":"<div><p>Social media challenges are activities performed by an individual or a group and uploaded to social media platforms to achieve a specific goal. We sought to understand how harmful social media challenges are portrayed on Reddit. Therefore, we analyzed 1,552 Reddit posts and 7,092 comments about inherently risky social media challenges (e.g., Cinnamon, Blue Whale, Fire). We found that posts discussed the participation of others (40%), perceptions on the challenges (24%), prevention/raising awareness (18%), seeking information (10%), and one's own participation in a challenge (8%). Comments included offensive commentary towards those who participated, tips and tricks on how to perform a challenge, and Reddit moderation of these posts. We uncovered that the affordances and social norms on Reddit contributed to a lack of propagation of harmful challenges on the platform. Our research contributes to an in-depth empirical understanding of how harmful social media challenges are discussed on Reddit and suggests ways to design affordances and reinforce positive social norms to prevent the spread of social media challenges that promote self-harm.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46045100","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":"The effect of cold hands on immediate responder's tourniquet application ability: A within-group trial","authors":"Wilhelm Brodin ,&nbsp;Marc Friberg ,&nbsp;Carl-Oscar Jonson ,&nbsp;Erik Prytz","doi":"10.1016/j.hfh.2023.100038","DOIUrl":"10.1016/j.hfh.2023.100038","url":null,"abstract":"<div><h3>Introduction</h3><p>Cold exposure generally has a negative effect on tasks that rely on finger dexterity. It is not known if cold exposure will affect immediate responder's ability to perform first aid for life-threatening bleedings, specifically tourniquet application.</p></div><div><h3>Study objective</h3><p>This study investigates the effect of cold exposure on immediate responder's tourniquet application ability and their experienced stress.</p></div><div><h3>Methods</h3><p>29 adult participants completed a tourniquet application test in a baseline condition and three partial cold immersion conditions where their hands were immersed in near 0 °C water. The three conditions lowered the participant's hand-skin temperature to 16 °C, 12 °C and 8 °C, respectively. Tourniquet application was conducted on the leg of a rescue manikin and was measured using a procedural checklist. Time until bleeding control and total application time was also measured. Stress was measured using the Short Stress State Questionnaire.</p></div><div><h3>Results</h3><p>The results show that cold exposure, specifically lowering hand-skin temperature to 8 °C, significantly increases the time to bleeding control (Baseline: <em>M</em> 65.5 s, <em>SD</em> 17.0 s; 8 °C: <em>M</em> 76.9 s, <em>SD</em> 19.6 s) and total application time (Baseline: <em>M</em> 77.1 s, <em>SD</em> 18.0 s; 8 °C: <em>M</em> 89.6 s, <em>SD</em> 21.3 s). No effect was found on application quality in any of the cold exposure conditions. The experience of stress regarding the application of tourniquets in cold conditions showed an increase in task engagement (Normalized change score 0.87, 95% CI [0.55, 1.19]), a decrease in worry (Normalized change score -1.01, 95% CI [-1.35, -0.67]) and no change in distress (Normalized change score -0.02, 95% CI [-0.45, 0.41]).</p></div><div><h3>Conclusion</h3><p>Cold exposure can decrease the chance of survival for the injured person when an immediate responder provides first aid for a massive bleed. Future research should be aimed at finding suitable mitigation strategies for the effect and testing their viability in the presence of additional stressors.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43069428","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":"Default bias in medical patient simulators: Differences in availability and procedures","authors":"Katelyn R. Schwieters,&nbsp;Nichole L. Morris,&nbsp;Curtis M. Craig","doi":"10.1016/j.hfh.2023.100040","DOIUrl":"10.1016/j.hfh.2023.100040","url":null,"abstract":"<div><h3>Introduction</h3><p>Default biases in the design of new medical training technologies may lead to disparities, especially for women and people of color in patient treatment and outcomes in prehospital emergency services and combat medicine. The goal of this work was to develop a taxonomy of medical patient simulators to determine their demographic makeup and whether there was evidence of default bias in product catalogs.</p></div><div><h3>Methods</h3><p>The authors identified 114 full-body patient simulators from seven major medical device companies. Simulator demographic information (e.g., patient sex/gender, race/skin tone) and simulator prehospital care procedure features (e.g., tension pneumothorax, massive hemorrhage) were cataloged using company website information sheets and product catalogs using a binary coding system. Procedures were further classified into two categories: sensitive procedures and non-sensitive procedures.</p></div><div><h3>Results</h3><p>Findings revealed that although several companies offer demographically diverse patient simulators, marketing of many existing patient simulators use the white, male body as the featured default patient. Female patient simulators and simulated patients of color were significantly less likely to have procedure capabilities that allow for the practice of treating sensitive areas of the body compared to default male patient simulators.</p></div><div><h3>Discussion</h3><p>Default bias in the design of medical patient simulators illustrate the importance of inclusive design to improve medical decision-making and reduce disparities in civilian and military patient outcomes and care. Practice implications include increasing the diversity of complex medical patient simulators, removing default selections, and featuring female and patients of color in product catalogs.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44404295","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":"Human factors in the hospital: Education, skills, and job details","authors":"Kristen Webster ,&nbsp;Laura Barg-Walkow ,&nbsp;Sarah Fouquet","doi":"10.1016/j.hfh.2023.100045","DOIUrl":"10.1016/j.hfh.2023.100045","url":null,"abstract":"<div><h3>Objective</h3><p>To present the job requirements and background Human Factors professionals may need to be prepared and succeed in health care facilities.</p></div><div><h3>Background</h3><p>Both hospitals and Human Factors professionals must be prepared for the predicted growth of Human Factors job openings in health care. Professionals transitioning from another industry or graduating from a Human Factors and Ergonomics (HFE) program may benefit from understanding what hospitals need, education requirements, and the compensatory landscape. To date, there is a lack of baseline information about Human Factors professional job details in health care.</p></div><div><h3>Method</h3><p>We surveyed hospital-embedded Human Factors professionals. We grouped respondents based on the amount of time dedicated to operations vs. research work.</p></div><div><h3>Results</h3><p>Of 32 respondents, 75% were women. Hospital-embedded professionals reported an average salary of $153,917 and a median salary of $149,481. Although more institutions required a master's degree, 25% of practitioners had a doctorate degree. Technical and interpersonal skills were similar between researchers and practitioners including data collection and teamwork.</p></div><div><h3>Conclusion</h3><p>Universities can use this information to tailor educational programs for HFE students interested in a health care track. Hospitals seeking HFE professionals can create targeted job descriptions. HFE professionals can assess their ability to transition into the health care setting.</p></div><div><h3>Application</h3><p>This information can be used by HFE professionals to assess their readiness to enter the hospital setting and negotiate compensation based on the current market. Hospitals can also use this to determine what skills HFE professionals bring.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42637432","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}