Evidence map›Paper›PMID 28802446›Full record

Observational studyApplied ergonomics2017

Toward a process-level view of distributed healthcare tasks: Medication management as a case study.

Nicole E Werner, Seema Malkana, Ayse P Gurses, Bruce Leff, Alicia I Arbaje

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Applied ergonomics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
7.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 48 citations in OpenAlex.

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  17. Human factors/ergonomics work system analysis of patient work: state of the science and future directions.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Nicole E WernerDepartment of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, United States; Center for Quality and Productivity Improvement, College of Engineering, University of Wisconsin-Madison, Madison, WI, United States; Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, WI, United States. Electronic address: nwerner3@wisc.edu.
Seema MalkanaDepartment of Medicine, Temple University Hospital, Philadelphia, PA, United States.
Ayse P GursesArmstrong Institute for Patient Safety and Quality, Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Civil Engineering and Systems Institute, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, United States.
Bruce LeffDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Community and Public Health, Johns Hopkins School of Nursing, Baltimore, MD, United States.
Alicia I ArbajeDivision of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Clinical Investigation, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
Johns Hopkins University · USNational Patient Safety Foundation · USTemple University Hospital · USUniversity of Wisconsin–Madison · US

Funding

Institute for Clinical and Translational ResearchKL2TR001077 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$9.2M
Older adult safety while receiving home health services after hospital dischargeK08HS022916 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI ARBAJE, ALICIA INES · 2014 to 2018
$785k
AHRQ HHS K08 HS022916NCATS NIH HHS KL2 TR001077
6 · The paper itself

Abstract

We aim to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). MM during older adults' hospital-to-skilled-home-healthcare (SHHC) transitions is a healthcare process with tasks distributed across people, organizations, and time. MM has typically been studied at the task level, but a process-level is needed to fully understand and improve MM during transitions. A process-level view allows for a broader investigation of how tasks are distributed throughout the work system through an investigation of interactions and the resultant emergent properties. We studied MM during older adults' hospital-to-SHHC transitions through interviews and observations with 60 older adults, their 33 caregivers, and 79 SHHC providers at 5 sites associated with 3 SHHC agencies. Study findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries. Findings highlight the importance of a process-level view of healthcare delivery occurring across system boundaries.

Indexed as

Medication Therapy ManagementProcess Assessment, Health CareTransitional CareAdultAgedAged, 80 and overFemaleHome Care ServicesHumansMaleMiddle AgedPatient DischargePatient TransferFrail elderlyHome care agenciesMedication managementProcessSociotechnical systemSystem boundariesTransitional careWork system

Identifiers

PMID28802446
PMCPMC8284998
OpenAlexW2736038465

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.