Application of participatory ergonomics to the redesign of the family-centred rounds process

Abstract

Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g. patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g. shared mental model, usability, workload consideration, systems approach) and process (e.g. top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g. formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g. family engagement, round efficiency) and patient outcome measures (e.g. patient satisfaction).

Abstract

Practitioner Summary: The application of participatory ergonomics (PE) to healthcare system redesign is limited. This study broadens PE application from designing individual tasks in specific jobs to address physical ergonomic issues to designing complex healthcare processes to address cognitive and organisational ergonomic issues.

Keywords:

• participatory ergonomics
• family-centred rounds
• healthcare system redesign
• pediatric hospital
• checklist

Acknowledgements

The authors would like to thank Betty Chewning, Michael J. Smith and Douglas A. Wiegmann for their comments and feedback.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

^1. This method is called confrontation in the French HFE literature (Faye and Falzon 2009; Mollo and Falzon 2004).

^2.http://cqpi.wisc.edu/pediatric-family-centered-rounds.htm

^3.http://cqpi.wisc.edu/pediatric-family-centered-rounds.htm

^4. The hospitalist and haematology/oncology services had different team structures. The senior resident on the hospitalist team and the fellow physician on the haematology/oncology team were assigned to be the holder of the FCR checklist.

^5.http://cqpi.wisc.edu/pediatric-family-centered-rounds.htm

Additional information

Funding

This study was supported by an AHRQ Health Services Research Demonstration and Dissemination [grant number R18 HS018680] (Cox, PI), and the Clinical and Translational Science Award (CTSA) programme, previously through the National Center for Research Resources (NCRR) [grant number 1UL1RR025011] and now by the National Center for Advancing Translational Science (NCATS) [grant number 9U54TR000021].