Exploring the effect of complex patients on care delivery tasks

Area of Science:

• Healthcare Management
• Patient Care Coordination
• Systems Engineering in Healthcare

Background:

• Complex patients with chronic conditions present unpredictable needs, straining healthcare resources.
• Understanding task variations is crucial for improving healthcare processes, especially for high-need populations.

Purpose of the Study:

• To explore the specific tasks involved in managing complex patients within anticoagulation therapy.
• To identify how patient complexity impacts care delivery and resource allocation in specialty clinics.

Main Methods:

• Analysis of interviews with 55 staff across six anticoagulation clinics.
• Application of the Systems Engineering Initiative for Patient Safety (SEIPS) work system framework.
• Qualitative description of complex patients and their influence on care processes.

Main Results:

• Identifying complex patients and their impact on tasks and clinic organization is critical.
• Managing complex patients involves tasks similar to non-complex patients but with increased frequency, intensity, and additional specific duties.
• A work system perspective revealed implications for task integration and resource allocation.

Conclusions:

• A complex patient management framework is proposed to guide workflow design in specialty clinics.
• This framework, grounded in the SEIPS model, advocates for integrated analysis to enhance resource allocation and care coordination.
• The study emphasizes the need for formal analysis to support high-quality, efficient, and safe healthcare for complex patients.