Designing Reliable Care Through Clinical Pathways: A Human Factors Framework

Area of Science:

• Healthcare Systems Engineering
• Human Factors Engineering
• Sociotechnical Systems Theory

Background:

• Healthcare delivery systems are complex, with quality and safety improvements often failing due to misaligned work systems, care processes, and clinical practices.
• Existing efforts struggle with sustained, system-wide impact.

Purpose of the Study:

• To present a practical, theory-informed framework integrating human factors and systems thinking.
• To guide the design and implementation of clinical pathways for reliable care delivery and system-level transformation.

Main Methods:

• Developed a conceptual framework synthesizing literature from human factors engineering, sociotechnical systems theory, and healthcare quality improvement.
• Organized healthcare delivery into work system, care processes, and outcomes domains.
• Used pediatric immunization as a case example.

Main Results:

• The framework highlights how system design misalignment causes variability in care processes and outcomes.
• Clinical pathways, supported by human factors strategies (decision support, simulation, debriefing), can enhance care reliability.
• Integration into workflows is expected to reduce missed opportunities and improve care consistency.

Conclusions:

• Clinical pathways are effective tools for translating system design principles into reliable healthcare.
• Human factors and systems-based approaches are crucial for pathway implementation.
• The framework offers a structured method for designing, implementing, and scaling pathways to improve care safety and consistency.