Human factors and ergonomics in home care: Current concerns and future considerations for health information technology

Abstract

Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention.

Getting what they need when they need it

“…The 26 family caregivers (60% Female; 96% Caucasian; 4% African American) had an average age of 52 years (range = 24-76 years) and either lived with (9) or near (17) the person with dementia.…”

“…For example, family caregivers currently encounter barriers to successfully meeting their information needs. A sociotechnical systems approach can be used to identify the current barriers to information needs at the system level so that future CHI address those barriers in the actual design [15][16][17][18]. Addressing the sociotechnical context of those barriers in the design of CHI can provide critical information about how to optimize the design of CHI to facilitate family caregiver information needs by addressing optimal ways to design to fit into family caregiver workflows, how to best present information in meaningful ways, how the design should interact with other tools, and how the design should address where it is going to be used.…”

Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature

“…Perhaps the most concerning finding regarding organisational factors is the pervasive lack across provider organisations of recognised standards and procedures for service delivery that is evident in the telecare literature [ 77 ]. Provision of operational guidelines and protocols is of primary importance in ensuring safe implementation and delivery of all ICT-based healthcare services [ 26 ]. The need to apply professional practice standards and have formal procedures and protocols govern home-based telecare services is evident, so as not to seriously compromise the safety and quality of patient care.…”

“…Research is therefore needed that reflects the multidimensional aspect of patient safety, where consideration is given to the unique conditions of the home as a site for the provision of healthcare, as well as to the roles of patients, caregivers and providers as key players in the larger system [ 22 ]. Human factors and ergonomics approaches have been suggested as a suitable means for conceptualising and examining safety and quality concerns in home-based healthcare, as it implies consideration of interdependencies and interactions between humans and a broad range of relevant socio-technical factors [ 22 , 26 , 27 ]. Within a human factors framework, the home can be conceptualised as a complex, holistic work system where the different yet interrelated elements of the system come together to influence work-flow and care processes over time, which again influence a range of patient, provider and organisational outcomes [ 12 , 27 , 28 ].…”

Exploration of nurses' perception about professionalism in home care nursing in Iran: a qualitative study

“…Home care nursing involves a wide range of technical and protective care for patients, post-discharge period, maintaining the health of the disabled and the elderly at home, preventing unnecessary hospitalization and meeting the daily needs of home health with the goal of rehabilitation, therapeutic and supportive care ( 7 ). Today, home care is gradually becoming an emerging industry, and becoming a common nursing model ( 8 ). Along with this change in healthcare systems, it seems a new generation of nurses have gone into professional careers ( 9 ).…”