The Human Factors of Home Health Care

Henriksen, K; Joseph, Anthony; Zayas‐Cabán, Teresa

doi:10.1097/pts.0b013e3181bd1c2a

Cited by 67 publications

(35 citation statements)

References 32 publications

(14 reference statements)

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“…The study identified four main actors, ten actions, and 37 unique artifacts across seven major types, all contributing to 21 possible patient care and work outcomes. Like other HFE studies of home- and community-based care (Henriksen, Joseph, & Zayas-Cabán, 2009; Mickelson et al, 2016; Or et al, 2011; Or et al, 2009), we found work system factors both common and unique factors compared to hospital- and clinic-based care. The broad categories of the Workflow Elements Model seen in prior work with, for example, hospitals, emergency rooms, and ambulatory care clinics (Unertl, Johnson, & Lorenzi, 2012; Unertl et al, 2010; Zheng, Ciemins, Lanham, Lindberg, & Man, 2015), were equally applicable to the community-based mental healthcare domain.…”

Section: Discussionsupporting

confidence: 78%

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia

et al. 2017

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Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 hours of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes.

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Section: Discussionsupporting

confidence: 78%

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia

et al. 2017

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“…self-care). Some have attempted to do so, drawing examples and suggesting definitions based on prior research (Henriksen et al, 2009; Holden, Carayon, et al, 2013; National Research Council, 2011; Zayas-Cabán & Valdez, 2012). In this study, we applied the general model in Figure 1 to gather and analyze empirical data from heart failure patients and their caregivers to further develop both the idea of the patient work system and to identify the work system factors specific to heart failure self-care.…”

Section: Introductionmentioning

confidence: 99%

The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers

2015

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Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in “patient-engaged human factors,” or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n=30) and their informal caregivers (n=14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients’ biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains—physical-spatial, social-cultural, and organizational—and multiple “spaces” such as “at home,” “on the go,” and “in the community.” Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, context, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work.

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“…Studies were excluded if: (1) they were not related to healthcare system redesign (e.g., Casler and Cook 2003; Wong and Richardson 2010), (2) they described best practices or methods (e.g., Beuscart-Zephir et al 2007; Henriksen, Joseph and Zayas-Caban 2009), (3) they only presented a research protocol (e.g., Hysong et al 2009; Marshall et al 2011), and (4) they reported on general quality improvement (e.g., Amoore and Ingram 2002; Mutter 2003). …”

Section: Methodsmentioning

confidence: 99%

A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety

2014

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Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how Human Factors and Ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified twelve projects representing 23 studies and addressing different physical, cognitive and organizational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care. Practitioner Summary Existing evidence shows that HFE-based healthcare system redesign has the potential to improve quality of care and patient safety. Healthcare organizations need to recognize the importance of HFE-based healthcare system redesign to quality of care and patient safety, and invest resources to integrate HFE in healthcare improvement activities.

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The Human Factors of Home Health Care

Abstract: By examining the major components and interdependencies of the home health care delivery system, a human factors perspective offers insights into ways that safety and quality can be compromised and can help pave the way for new modes of thinking in home health care policy.

Cited by 67 publications

References 32 publications

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia

The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers

A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety

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