Journal
APPLIED ERGONOMICS
Volume 88, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.apergo.2020.103141
Keywords
Care transitions; Work systems; Sociotechnical systems; Older adults; Emergency department
Categories
Funding
- Provost's Multidisciplinary Award, University of Rochester, Rochester, New York, United States
- Shapiro Summer Research Program, University of Wisconsin-Madison (UW-Madison) School of Medicine and Public Health, Madison, Wisconsin, United States
- KL2 grant from the Institute for Clinical and Translational Research (ICTR), UW-Madison, Madison, United States, through the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS), United States [KL2TR002374, 1UL1TR002373]
- National Institute on Aging, NIH, United States [K24AG054560]
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Care transitions across healthcare settings, specifically between the emergency department (ED) and the home, are pervasive among older adults, and represent persistent healthcare quality and safety challenges. Care transitions cross multiple distinct work systems, representing a conceptual and methodological challenge for the field of Human Factors/Ergonomics - how to analyze a process that occurs across multiple work systems. As an initial step in determining how to study care transitions across work systems, we applied the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model, specifically the concept of configuration, to explore older adults' ED-to-home transitions. Our results suggest that configuration is useful for identifying and modeling work system barriers that interact across systems, but does not explicitly allow for the identification and analysis of the system boundaries that are crossed. To fully capture the complexity associated with care transitions, future iterations of SEIPS should introduce a mechanism to capture specific boundary types, so that system analysis can capture when and which boundaries are crossed.
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