SEIPS-based process modeling in primary care

Wooldridge, Abigail R.; Carayon, Pascale; Hundt, Ann Schoofs; Hoonakker, Peter

doi:10.1016/j.apergo.2016.11.010

Cited by 75 publications

(47 citation statements)

References 41 publications

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“…Changes, such as the Coordination Reform or cuts in staffing, can therefore affect organizational outcomes [39]. More specifically, a human factors perspective can be suitable for understanding the organization and context of primary healthcare services and how this affects variation in readmission rates [40]. Our study shows that the readmission rates have evened out during the period of study and factors that might explain why, relate to competence level, staffing level, physician coverage, time of discharge from hospital, interaction between hospital and nursing home, and nursing home organization (Fig.…”

Section: Discussionmentioning

confidence: 99%

Nursing home leaders’ and nurses’ experiences of resources, staffing and competence levels and the relation to hospital readmissions – a case study

Glette

Røise

Kringeland

et al. 2018

BMC Health Serv Res

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BackgroundThirty-day hospital readmissions represent an international challenge leading to increased prevalence of adverse events, reduced quality of care and pressure on healthcare service’s resources and finances. There is a need for a broader understanding of hospital readmissions, how they manifest, and how resources in the primary healthcare service may affect hospital readmissions. The aim of the study was to examine how nurses and nursing home leaders experienced the resource situation, staffing and competence level in municipal healthcare services, and if and how they experienced these factors to influence hospital readmissions.MethodThe study was conducted as a comparative case study of two municipalities affiliated with the same hospital, chosen for historical differences in readmission rates. Nurses and leaders from four nursing homes participated in focus groups and interviews. Data were analyzed within and across cases.ResultsThe analysis resulted in four common themes, with some variation in each municipality, describing nurses’ and leaders’ experience of the nursing home resource situation, staffing level and competence and their perception of factors affecting hospital readmissions. The nursing home patients were described as becoming increasingly complex with a subsequent need for increased nurse competence. There was variation in competence and staffing between nursing homes, but capacity building was an overall focus. Economic limitations and attempts at saving through cost-cutting were present, but not perceived as affecting patient care and the availability of medical equipment. Several factors such as nurse competence and staffing, physician coverage, and adequate communication and documentation, were recognized as factors affecting hospital readmissions across the municipalities.ConclusionSeveral factors related to nurses’ and leaders’ experience of the resource situation, staffing and competence level were suggested to affect hospital readmissions and the municipalities were similar in their answers regarding these factors. Patients were perceived as more complex with higher patient mortality forcing long-term nursing homes to shift towards an acute care or palliative function, and short-term nursing homes to function as “small hospitals”, requiring higher nurse competence. Staffing, competence and physician coverage did not seem to have adjusted to the new patient group in some nursing homes.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3769-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Nursing home leaders’ and nurses’ experiences of resources, staffing and competence levels and the relation to hospital readmissions – a case study

Glette

Røise

Kringeland

et al. 2018

BMC Health Serv Res

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“…Some of the previous studies on proactive risk assessment primarily focus on hazards -or "risk factors" that increase the probability of errors or injuries in healthcare settings (e.g. Carayon et al, 2006;Carayon et al, 2014;Karnon et al, 2007;Wooldridge et al, 2017). In addition, there have been few studies on proactive risk assessment of surgical site infections in ambulatory surgical centers (e.g.…”

Section: Brief Literature Reviewmentioning

confidence: 99%

A Proactive Risk Assessment Framework to Enhance Patient Safety: Analysis of Unintended Retained Foreign Objects in Operating Rooms

Tabibzadeh

Patel

2020

Proceedings of the International Symposium on Human Factors and

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According to a study by Johns Hopkins, in average 251,454 Americans die annually from preventable medical errors. Medical error is the third leading cause of death in the U.S. after heart disease and cancer. Among different adverse events in healthcare settings, unintended retained foreign objects (URFOs) has been identified as the most common sentinel event by The Joint Commission. This paper proposes a proactive risk assessment framework to enhance patient safety in operating rooms by addressing the URFOs issue. The risk assessment framework is developed by integrating the 10 traits of a positive safety culture, initially introduced by the Nuclear Regulatory Commission, with an accident investigation framework called AcciMap, originally developed by Rasmussen. The AcciMap is a hierarchical framework, which comprises six layers: government and regulatory bodies, company, management, staff and work. In this study, it has been utilized to capture and analyze socio-technical contributing causes of URFOs across its layers in order to assess the activities of key players in each layer as well as the interactions between those layers. Moreover, we have been able to identify the most influential traits of a positive safety culture affecting the URFOs issue.

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Section: Brief Literature Reviewmentioning

confidence: 99%

A Proactive Risk Assessment Methodology to Enhance Patient Safety: Reducing Wrong Site Surgery as a Preventable Medical Error

Tabibzadeh

Jahangiri

2020

Proceedings of the Human Factors and Ergonomics Society Annual

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Patient safety has been a major area of concern over the last decades in the healthcare industry. The number of preventable medical errors in hospitals has been noticeably high. These errors are more likely to occur in intensive care units including Operating Rooms (ORs). Wrong site surgery is one of the critical sentinel events that occur in healthcare settings. This paper fills an important gap by proposing an integrated, system-oriented methodology for proactive risk assessment of operations in ORs, to specifically analyze the wrong site surgery issue, through the identification and monitoring of appropriate Leading Safety Indicators (LSIs) to evaluate the safety of those operations and generate warning/predicting signals for potential failures. These LSIs are identified across the layers of an introduced framework, which is built on the foundation of the Human-Organization-Technology (HOT) model originally developed by Meshkati (1992). This multi-layered framework captures the contributing causes of wrong site surgery.

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SEIPS-based process modeling in primary care

Cited by 75 publications

References 41 publications

Nursing home leaders’ and nurses’ experiences of resources, staffing and competence levels and the relation to hospital readmissions – a case study

Nursing home leaders’ and nurses’ experiences of resources, staffing and competence levels and the relation to hospital readmissions – a case study

A Proactive Risk Assessment Framework to Enhance Patient Safety: Analysis of Unintended Retained Foreign Objects in Operating Rooms

A Proactive Risk Assessment Methodology to Enhance Patient Safety: Reducing Wrong Site Surgery as a Preventable Medical Error

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