Using human centred design and human factors to support a rapid health information technology patient safety response

运用以人为本的设计和人因工程原理,支持快速响应医疗信息技术患者安全问题

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Abstract

BACKGROUND: Human centred design (HCD) and human factors (HF) approaches can support the safe design and redesign of Health Information Technologies (HITs). Safety issues associated with HITs can occur due to complex sociotechnical and contextual factors which dynamically impact safety. An effective rapid HIT patient safety response could resolve issues before patient harm occurs. AIM: To describe, evaluate, and generate recommendations for optimising the application of HCD and HF methods by non-HF experts during a rapid statewide HIT patient safety response. METHODS: In response to reported safety issues with a HIT, HCD and HF approaches were used by non-HF experts during site visits to understand the issues, contextual differences between sites and gather preliminary feedback on proposed redesign options to mitigate the issues. This quality improvement study involved two 45-minute focus groups with 7 staff who conducted the site visits to understand what worked well, what did not work well, and any lessons learnt relating to the application of HCD and HF informed data collection approaches during this patient safety response. RESULTS: Outcomes from the site visits were reported to be variable. However, the overall data collection approach was considered effective in gathering useful information. Participants explained that key outcomes of the approach used included improved understanding of the issues and contributing contextual factors, effective engagement with sites and users, and increased team collaboration and job satisfaction among the data collection team. Participants identified factors that influenced the effectiveness of site visits including data collection approaches (e.g., individual vs group data collection), the circumstances on the day (e.g., time and availability of frontline staff), contextual factors (e.g., the nature of the unit/setting) and factors related to the data collection team (e.g., selection of team members involved). Recommendations have been provided to optimise future rapid HIT patient safety responses. CONCLUSION: Data collection approaches informed by HCD and HF methods are useful for understanding and addressing HIT safety concerns requiring rapid responses, even when applied by non-HF experts. Ideally, methods should be applied flexibly and involve seeking insights from frontline users in their own environments.

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