The national health information technology human factors and ergonomics agenda

Zayas‐Cabán, Teresa; White, Patricia

doi:10.1016/j.apergo.2020.103109

Cited by 11 publications

(3 citation statements)

References 39 publications

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“…Human factors engineering–focused solutions can be described for each of the nine scenarios. For example, redesign of man-machine interfaces has the potential to reduce the risk for the first 4 scenarios—computerized order entry and programmable pumps 25–32 . Recognition of the complexity of medical oncology care could lead to the development of checklists and other tools to reduce risk, especially in the setting of highly complicated clinical trials where several concerning incidents were identified 33 .…”

Section: Discussionmentioning

confidence: 99%

“…For example, redesign of man-machine interfaces has the potential to reduce the risk for the first 4 scenarios-computerized order entry and programmable pumps. [25][26][27][28][29][30][31][32] Recognition of the complexity of medical oncology care could lead to the development of checklists and other tools to reduce risk, especially in the setting of highly complicated clinical trials where several concerning incidents were identified. 33 In some high-risk industries, cross-checking has been shown to have limited value, yet in medical oncology, we rely heavily on double checks for chemotherapy preparation and administration.…”

Section: Secondary Analysismentioning

confidence: 99%

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Uncovering the Risks of Anticancer Therapy Through Incident Report Analysis Using a Newly Developed Medical Oncology Incident Taxonomy

Jacobson,

Zerillo,

Doolin

et al. 2023

J Patient Saf

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Background Incident reporting systems were developed to identify possible and actual harm in healthcare facilities. They have the potential to capture important safety trends and to enable improvements that can mitigate the risk of future patient harm and suffering. We recently developed and validated a taxonomy specific for medical oncology designed to enhance the identification, tracking, and trending of incidents that may lead to patient harm. The current project was designed to test the ability of such a taxonomy to be applied across different organizations delivering medical oncology care and to identify specific risks that could result in future harm. Methods We analyzed 309 randomly selected medical oncology–related incident reports from 3 different cancer centers that had been posted between January 2019 and December 2020. Each report was assigned up to 2 incident categories. We used a 2-step process to reconcile reviewer discrepancies. In a secondary analysis, each of the incidents was reviewed and recoded to identify events which may result in major or catastrophic harm. Results Three hundred four incidents met criteria for inclusion. Three hundred incidents (98.7%) were successfully coded. Sixty-seven percent of incidents were encompassed by the following 4 of 21 categories: prescriber ordering (22%), nursing care (15%), pharmacy (14%), and relational/communication issues (15%). Of 297 evaluable incidents, 47% did not reach the patient, 44.7% reached the patient without harm, 7.7% caused minor injury, and 0.7% caused severe injury or death. Submission rates by physicians varied between the 3 sites accounting for 1.7%, 10.7%, and 16.1% of reports. Secondary analysis identified 9 distinct scenarios that may result in major or catastrophic patient harm. Conclusions A medical oncology–specific incident reporting taxonomy has the potential to increase our understanding of inherent risks and may lead to process improvements that improve patient safety.

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Section: Discussionmentioning

confidence: 99%

Section: Secondary Analysismentioning

confidence: 99%

Uncovering the Risks of Anticancer Therapy Through Incident Report Analysis Using a Newly Developed Medical Oncology Incident Taxonomy

Jacobson,

Zerillo,

Doolin

et al. 2023

J Patient Saf

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“…One potential mechanism relating to HIT use and burnout may be frustration with technology-an emotional reaction to an obstacle preventing the fulfillment of a perceived need [23]. HIT is at risk for inducing frustration among health care workers, by virtue of its complex interfaces, frequent updates as capabilities improve, and deployment within a high-stakes environment that provides limited opportunity for dedicated training [24][25][26]. If frustration with technology contributes to emotional exhaustion, this would indicate an opportunity to prioritize reducing frustration through better design, training, and implementation as a mechanism to combat burnout [27].…”

Section: Introductionmentioning

confidence: 99%

Frustration With Technology and its Relation to Emotional Exhaustion Among Health Care Workers: Cross-sectional Observational Study

Tawfik¹,

Sinha²,

Bayati³

et al. 2021

J Med Internet Res

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Background New technology adoption is common in health care, but it may elicit frustration if end users are not sufficiently considered in their design or trained in their use. These frustrations may contribute to burnout. Objective This study aimed to evaluate and quantify health care workers’ frustration with technology and its relationship with emotional exhaustion, after controlling for measures of work-life integration that may indicate excessive job demands. Methods This was a cross-sectional, observational study of health care workers across 31 Michigan hospitals. We used the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey to measure work-life integration and emotional exhaustion among the survey respondents. We used mixed-effects hierarchical linear regression to evaluate the relationship among frustration with technology, other components of work-life integration, and emotional exhaustion, with adjustment for unit and health care worker characteristics. Results Of 15,505 respondents, 5065 (32.7%) reported that they experienced frustration with technology on at least 3-5 days per week. Frustration with technology was associated with higher scores for the composite Emotional Exhaustion scale (r=0.35, P<.001) and each individual item on the Emotional Exhaustion scale (r=0.29-0.36, P<.001 for all). Each 10-point increase in the frustration with technology score was associated with a 1.2-point increase (95% CI 1.1-1.4) in emotional exhaustion (both measured on 100-point scales), after adjustment for other work-life integration items and unit and health care worker characteristics. Conclusions This study found that frustration with technology and several other markers of work-life integration are independently associated with emotional exhaustion among health care workers. Frustration with technology is common but not ubiquitous among health care workers, and it is one of several work-life integration factors associated with emotional exhaustion. Minimizing frustration with health care technology may be an effective approach in reducing burnout among health care workers.

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