Abstract
We aim to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). MM during older adults’ hospital-to-skilled-home-healthcare (SHHC) transitions is a healthcare process with tasks distributed across people, organizations, and time. MM has typically been studied at the task level, but a process-level is needed to fully understand and improve MM during transitions. A process-level view allows for a broader investigation of how tasks are distributed throughout the work system through an investigation of interactions and the resultant emergent properties. We studied MM during older adults’ hospital-to-SHHC transitions through interviews and observations with 60 older adults, their 33 caregivers, and 79 SHHC providers at 5 sites associated with 3 SHHC agencies. Study findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries. Findings highlight the importance of a process-level view of healthcare delivery occurring across system boundaries.
Original language | English (US) |
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Pages (from-to) | 255-268 |
Number of pages | 14 |
Journal | Applied Ergonomics |
Volume | 65 |
DOIs | |
State | Published - Nov 2017 |
Keywords
- Frail elderly
- Home care agencies
- Medication management
- Process
- Sociotechnical system
- System boundaries
- Transitional care
- Work system
ASJC Scopus subject areas
- Human Factors and Ergonomics
- Physical Therapy, Sports Therapy and Rehabilitation
- Safety, Risk, Reliability and Quality
- Engineering (miscellaneous)