Investigating a Work System Approach to Implement an Emergency Department Surge Management System: Case Study

Area of Science:

• Health Informatics
• Healthcare Management
• Systems Engineering

Background:

• Emergency department (ED) crowding is a significant global healthcare challenge.
• eHealth systems offer potential solutions but often fail due to poor integration into clinical workflows.
• Understanding how to structure eHealth system implementation for true workflow integration is crucial.

Purpose of the Study:

• To evaluate Work System Theory (WST) as a framework for structuring eHealth system implementation.
• To identify the roles of WST's static framework and dynamic life cycle model in implementation success.
• To demonstrate the application of WST in guiding healthcare eHealth system implementations.

Main Methods:

• A mixed-methods case study was conducted in a rural hospital's ED, focusing on a surge management system implementation.
• Data collection included observations, interviews, surveys, documentation review, and analysis of ED wait time data.
• Template analysis based on WST and descriptive statistics were used for data analysis.

Main Results:

• The eHealth surge management system reduced ED crowding and wait times, with improvements sustained over years.
• High staff satisfaction (72%) and perceived workflow integration (82%) were reported.
• WST application facilitated the identification and alignment of work system elements and managed iterative changes effectively.

Conclusions:

• Work System Theory (WST) provides a suitable, holistic approach for guiding eHealth system implementations by considering the entire work system.
• Applying WST to an ED surge management system implementation demonstrated its practical utility in healthcare.
• These findings support the use of WST for future eHealth system implementations to enhance integration and effectiveness.