|Excerpt of the presentation|
Walid Elias Kai
Objectives: A focus on human-centric processes is necessary for healthcare organizations to realize the full benefits of information technology advances. The goal of information technology in healthcare is to provide simplified, convenient access to meaningful information for human beings as they communicate and collaborate in the course of providing care. The current rate of technology change, however, often leads to an excess of complex devices and complicated information that provides more cognitive burdens than it relieves. The challenge for information technology in healthcare is to provide processes and techniques to contain the rate of change and variability and thus reduce or eliminate the barriers to effective use of information technology in improving quality and patient safety.
Study design: Human-Centric Processes Human beings are dynamic and unpredictable, with imperfect memories. We frequently misunderstand symbols, words, and expressions and have insufficient knowledge of new or unfamiliar domains. Advances in technology often lead to excesses of information that tax the human information processing system beyond that which is necessary to accomplish the task at hand. Thus, it is imperative that systems be designed from a perspective that optimizes human strengths and accommodates weaknesses. Three increasingly specific areas that focus on the human element in man-machine systems include human factors, human-computer interaction, and computer-supported collaborative work.
Methods: Nielsens Usability Heuristics Nielsen13 lists a number of design heuristics for the user interface, as shown in Table 8-1. The emphasis on human-computer interaction and usability testing will increase as software supports a greater number of tasks that were previously performed manually. For example, electronic ordering systems should present all the information necessary for a clinician to make the correct decision clearly. Usability testing and evaluation techniques are necessary to measure how well a software system meets these requirements.
Conclusions: Healthcare organizations that focus only on point solutions
will introduce additional errors either from automating faulty processes
or from failures associated with technology. Leaders of healthcare organizations
should focus on system-wide processes and implement technologies appropriately.
By focusing on the human element in the system, the full benefits of
information technology can be realized and errors can be avoided. 1.
Implement a system-wide approach to preventing, avoiding, detecting,
and recovering from errors. The first step is to understand that complex
systems result in errors caused by fragmented processes and organizations.
Many of the barriers to error reduction are cultural or psychological.
Individuals operating within a punitive environment are often reluctant
to admit an error was made. In other cases, the lack of a system-wide
approach fails to yield enough information to understand the true cause
of an error. Dealing with complexity is something that requires human
intervention. In health care, we focus on individual carefulness and
expect that to prevent errors, said speaker Martin J. Hatlie, a lawyer
and president of Chicago-based Partnership for Patient Safety.9 The
bigger and more complex you make it, the more places there are for it
to break down. Medical errors are often the result of complex interactions
of individuals performing their jobs correctly. The root-cause analysis
attempts to address the complexity of a system to uncover the cause,
not just the obvious subsequent consequences of the cause. It recognizes
that human activities are error prone and includes the human factor
in the analysis.22 Implementing such a process may require reorganizing
or repurposing current staff and requires collaboration among staff
and administration to ensure a nonpunitive culture that learns from
errors. At the Luther-Midelfort Hospital, initial investigations revealed
approximately 200 to 230 potential medication errors for every 100 charts.23
Improvement came with an organizational change featuring strong leadership
and a focus on individual processes, including admissions, transfers,