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Toward a process-level view of distributed healthcare tasks: Medication management as a case study
Nicole E Werner1, Seema Malkana2, Ayse P Gurses3
1Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, United States; Center for Quality and Productivity Improvement, College of Engineering, University of Wisconsin-Madison, Madison, WI, United States; Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, WI, United States.
Applied Ergonomics
|August 14, 2017
Summary
Analyzing medication management (MM) during older adult transitions requires a process-level view, not just task-level analysis. This approach reveals system-wide issues and barriers for better healthcare delivery.
Area of Science:
- Healthcare Systems Engineering
- Patient Transition Management
- Medication Safety
Background:
- Medication management (MM) during transitions from hospital to skilled home healthcare (SHHC) is complex, involving distributed tasks across multiple stakeholders.
- Traditional task-level analysis of MM often misses critical system-level dynamics and emergent properties.
- Older adults are particularly vulnerable during these transitions, necessitating improved MM processes.
Purpose of the Study:
- To emphasize the necessity of a process-level perspective for analyzing distributed healthcare tasks.
- To investigate medication management (MM) during older adults' hospital-to-skilled-home-healthcare (SHHC) transitions using a case study approach.
- To identify and understand emergent properties and barrier propagation across system boundaries in MM.
Main Methods:
- A qualitative case study methodology was employed.
- Data collection involved interviews and observations.
- Participants included 60 older adults, 33 caregivers, and 79 SHHC providers across 5 sites and 3 SHHC agencies.
Main Results:
- A process-level view revealed emergent properties such as role ambiguity and loosely-coupled teams in MM, which are not apparent at the task level.
- The study identified key barriers to effective MM during transitions that propagate across system boundaries.
- Cross-system characteristics and their impact on MM were highlighted, underscoring the limitations of task-level analysis.
Conclusions:
- A process-level view is crucial for comprehending and improving medication management during patient transitions across healthcare systems.
- Understanding emergent properties and barrier propagation is essential for optimizing healthcare delivery at system boundaries.
- This approach provides a more holistic understanding of distributed healthcare tasks, leading to enhanced patient safety and care quality.
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