Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital

Abstract

Human factors and ergonomics methods are needed to redesign healthcare processes and support patient-centered care, in particular for vulnerable patients such as hospitalized children. We implemented and evaluated a stimulated recall methodology for collective confrontation in the context of family-centered rounds. Five parents and five healthcare team members reviewed video records of their bedside rounds, and were then interviewed using the stimulated recall methodology to identify work system barriers and facilitators in family-centered rounds. The evaluation of the methodology was based on a survey of the participants, and a qualitative analysis of interview data in light of the work system model of Smith and Carayon (1989; 2000). Positive survey feedback from the participants was received. The stimulated recall methodology identified barriers and facilitators in all work system elements. Participatory ergonomics methods such as the stimulated recall methodology allow a range of participants, including parents and children, to participate in healthcare process improvement.

Family-Centered Care for Hospitalized Children: Concept Analysis

“…그러므로 의료진은 가족 에게 가능한 쉬운 단어를 사용하여 내용을 전달하고 [11,15,22,24], 언 어뿐만 아니라 문화의 차이를 이해하여 가족의 문화적 요구도 충분히 고려해야 하며, 필요시 통역사를 활용할 수 있다 [5,19,23]. 특히 중재자 로서의 간호사의 참여는 의사소통 측면의 효과를 극대화하여 가족의 이해를 도울 수 있다 [16,25].…”

“…Empowerment and reinforcement 4,5,15,17,21,22 Obstacle High expectation of family 9,10,13 Negative opinion of medical staff 9,10,13,20 Strategy Leadership 14 Participation of family 17,19 Continuing support from staff 14,17,19,22 Communication Description Improving communication 3,10,15,18 Consideration for family 10,18,21 Sharing care plan 3,15,21 Obstacle Language barrier 4,7,11,15,19 Poor understanding 10,11,15,17 Handing out bad news 9,12 Strategy Using easy words 4,6,15,22 Interpreter training 19 Mediative participation of nurse 1,16,25 Understanding of culture …”

SEIPS-based process modeling in primary care

“…The process map and accompanying table are used to evaluate the process; this evaluation is based on identification of barriers and facilitators (Carayon, DuBenske, et al, 2011; Carayon et al, 2005; Carayon, Li, et al, 2014; Gurses & Carayon, 2007). Barriers and facilitators can be found throughout the work system (Carayon, Wetterneck, et al, 2014) and are often related to specific steps in the process.…”

Multi-stakeholder collaboration in the redesign of family-centered rounds process

“…In the pediatric setting, FCR are recommended as standard practice to engage families in the care of hospitalized children (Committee on Hospital Care and Institute for Patient- and Family-Centered Care, 2012). Various work system barriers (e.g., disruption of workflow, healthcare team size, physical room constraints), however, can hinder family engagement in FCR (Carayon et al, 2011; Mittal et al, 2010). To improve family engagement in FCR, these system barriers need to be addressed and the FCR process and related work system need to be redesigned (Kelly et al, 2013).…”

“…Stakeholder representatives on the IIT were expected to actively participate in the meetings and communicate with their colleagues in between meetings. Other FCR stakeholders who did not participate in the IIT were able to voice their opinions and contribute to the redesign process through different mechanisms, e.g., interviews (Carayon et al, 2011; Carayon, Li, et al, 2014; Kelly et al, 2013), surveys (Xie et al, 2012) and the pilot study of the intervention (Li et al, 2013). …”