Identifying system adaptations to overcome technology-based workflow challenges in a telephone triage organization

Area of Science:

• Healthcare systems engineering
• Human-computer interaction
• Sociotechnical systems analysis

Background:

• Call-center telephone triage is a complex sociotechnical system.
• Digital technologies, like computer decision support systems, are used to standardize triage outcomes.
• Little consideration is given to how these systems adapt to real-world operating challenges.

Purpose of the Study:

• Investigate the effects of technology design on workflow and system adaptations in telephone triage.
• Identify opportunities for improving assessment prompts and software updates.
• Understand how unique healthcare systems adapt to maintain functionality.

Main Methods:

• Structured observations of call handlers in two call centers.
• Application of usability heuristics.
• Analysis guided by the concept of 'workarounds'.

Main Results:

• Technology design significantly impacts workflow and necessitates system adaptations.
• Individual and organizational adaptations are crucial for safe caller triage.
• Opportunities for improvement exist in assessment prompts and software dynamism.

Conclusions:

• System designers must consider the dynamic nature of real-world healthcare challenges.
• Improving technology design can enhance the safety and efficiency of telephone triage.
• Adaptations in sociotechnical systems are essential for maintaining functionality under pressure.