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Related Experiment Video

Updated: Sep 13, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Learning from workarounds in barcode medication administration: a Safety-II perspective.

Danielli Cossul1, Tarcisio Abreu Saurin1, Rosana da Silva Fraga2

  • 1Industrial Engineering Post-Graduate Program, Universidade Federal do Rio Grande do Sul, Brazil.

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Summary
This summary is machine-generated.

Learning from healthcare workarounds (WAs) is key for improvement. This study offers guidelines for learning from WAs, focusing on risk reduction and a Safety-II perspective to build resilient healthcare systems.

Keywords:
Barcode medicationHealth servicesLearningSafety-IIWorkarounds

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Area of Science:

  • Healthcare Informatics
  • Patient Safety
  • Human Factors Engineering

Background:

  • Workarounds (WAs) in healthcare digital technologies are prevalent.
  • Existing research lacks methods for learning from WAs to drive improvements.
  • A Safety-II perspective, acknowledging context-dependency and mixed outcomes of WAs, is crucial.

Purpose of the Study:

  • To introduce guidelines for learning from workarounds in healthcare.
  • To provide an empirical foundation for these guidelines using a case study.
  • To inform the design of learning systems that support resilient healthcare.

Main Methods:

  • Case study of barcode medication administration in a large hospital.
  • Mixed-methods data collection: documentary analysis, shadowing, interviews, focus groups, surveys (risk assessment and psychological safety).
  • Analysis of workarounds, contributing factors, and outcomes.

Main Results:

  • Identified 22 workarounds with 43 contributing factors.
  • Documented nine potential desired and nine potential undesired outcomes.
  • Developed five learning guidelines focusing on risk prioritization, reduction, data-driven insights, WA limitations, and Safety-II language.

Conclusions:

  • Tackling contributing factors is essential for reducing WA frequency and risks.
  • The proposed guidelines can enhance learning from workarounds.
  • These guidelines support the development of resilient healthcare systems by leveraging insights from WAs.