Application of participatory ergonomics to the redesign of the family-centred rounds process

Abstract

Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g. patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g. shared mental model, usability, workload consideration, systems approach) and process (e.g. top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g. formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g. family engagement, round efficiency) and patient outcome measures (e.g. patient satisfaction).

Keywords: checklist; family-centred rounds; healthcare system redesign; participatory ergonomics; pediatric hospital.

Figures

Figure 1

Timeline of the PE Process.

Figure 2

Initial design of the FCR intervention.

Figure 2

Initial design of the FCR intervention.

Figure 3

Final version of the FCR checklist.

Figure 3

Final version of the FCR checklist.

Figure 4

Evaluation of IIT meetings.

Figure 4

Evaluation of IIT meetings.

Figure 4

Evaluation of IIT meetings.

Figure 5

FCR checklist use during pilot study (N=47 rounds).