A Human Factors Subsystems Approach to Trauma Care

Abstract

Deployment of complex subsystem interventions based on detailed human factors engineering and a systems analysis of the provision of trauma care resulted in reduced flow disruptions, treatment time, and length of stay.

Work conditions, mental workload and patient care quality: a multisource study in the emergency department

“…Our results emphasise that ED systems design should ideally reduce unnecessary workflow interruptions and multitasking demands 16. Particularly with the objective to manage workload in an efficient and safe manner to create high-quality and efficient front-end operations in the ED.…”

“…Our study does not allow definite causal inferences, for example, we cannot clearly delineate whether increased workflow interruptions decrease patients’ general satisfaction with ED care (cf., table 2) or whether patients who are unsatisfied with treatment and care tend to interrupt staff more frequently. However, based on evidence in other settings we propose that highly interruptive work environments in the hospital influence clinical performance 13 16 33. There may have been confounders present that were not controlled for and that contribute to each of those associations we observed.…”

“…Concerning our finding that mental workload has an immediate effect on patient care, work redesign and training of cognitive strategies to ED providers to reorient themselves after a disruption may be helpful in dealing with interruptive ED work. ED workplace changes should be carefully evaluated for the effect of ED provider interruption and efficiency of communication 4 16…”

“…In order to understand the complex, dynamic and unpredictable nature of ED environments, it is necessary to conduct studies that comprehensively address the multiple characteristics of ED work demands as well as relevant patient outcomes 1 2 16. Although previous studies have demonstrated the occurrence of intense demands in emergency care, potential effects of these on patient care quality and provider outcomes in emergency care have been investigated less frequently 2 17.…”

“…Although previous studies have demonstrated the occurrence of intense demands in emergency care, potential effects of these on patient care quality and provider outcomes in emergency care have been investigated less frequently 2 17. Moreover, studies are needed that address the effects of interruptive and demanding ED environments on patient care quality 12 15 16 18. Despite striving to accomplish efficient care in the ED, workflow interruptions and multitasking demands may be inherent to the complex, cognitive system in the ED 1.…”