Toward a process-level view of distributed healthcare tasks: Medication management as a case study

Nicole E. Werner, Seema Malkana, Ayse P. Gurses, Bruce Leff, Alicia I. Arbaje

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


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 languageEnglish (US)
Pages (from-to)255-268
Number of pages14
JournalApplied Ergonomics
StatePublished - Nov 2017


  • 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)


Dive into the research topics of 'Toward a process-level view of distributed healthcare tasks: Medication management as a case study'. Together they form a unique fingerprint.

Cite this