That's nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of care

Health information technology (IT) is widely endorsed as a way to improve key health care outcomes, particularly patient safety. Applying a human factors approach, this paper models more explicitly how health IT might improve or worsen outcomes. The human factors model specifies that health IT transforms the work system, which transforms the process of care, which in turn transforms the outcome of care. This study reports on transformations of the medication administration process that resulted from the implementation of one type of IT: bar coded medication administration (BCMA). Registered nurses at two large pediatric hospitals in the US participated in a survey administered before and after one of the hospitals implemented BCMA. Nurses’ perceptions of the administration process changed at the hospital that implemented BCMA, whereas perceptions of nurses at the control hospital did not. BCMA appeared to improve the safety of the processes of matching medications to the medication administration record and checking patient identification. The accuracy, usefulness, and consistency of checking patient identification improved as well. In contrast, nurses’ perceptions of the usefulness, time efficiency, and ease of the documentation process decreased post-BCMA. Discussion of survey findings is supplemented by observations and interviews at the hospital that implemented BCMA.

Relevance to industry

By considering the way that IT transforms the work system and the work process a practitioner can better predict the kind of outcomes that the IT might produce. More importantly, the practitioner can achieve or prevent outcomes of interest by using design and redesign aimed at controlling work system and process transformations.     

A study on the student pilot's mental workload due to personality types of both instructor and student

The main purpose of this paper is to provide the ideal flight crew combination for instructor and student pilots in order to enhance the flight training effects based on Myers Briggs Type Indicator (MBTI) theory. In addition to personality, various levels of flight difficulty are considered in order to investigate their potential interaction effect in terms of student pilots' mental workload measured in heart rate, altitude deviation, NASA-TLX (Task Load Index) and subjective degree of personality harmony. Based on an experiment performed in a real flight situation, we found significant effects of personality combinations in terms of all four outcome measures. Both group C types of instructors and students who are concrete, realistic and have mechanical skills turn out to be the ideal flight crew combination. A structural equation model, fitted to analyse causality among the four response variables, implied that as the heart rate increased, the altitude deviation increased. In addition, as the altitude deviation and personality harmony increased, NASA-TLX increased. The results of this study are expected to provide a theoretical basis for manning the flight crew combinations and thereby enhancing the efficiency of flight training.     

Assessment of pilot performance and mental workload in rotary wing aircraft

This research examined the processing demands imposed upon experienced pilots by two different communication formats, digital and verbal, in a high fidelity simulation of an advanced multi-function helicopter. The mental workload imposed by die type and magnitude of communications was assessed by a battery of subjective, performance, secondary, and physiological measures. The performance data indicated that the pilots had difficulty adhering to the Nap of the Earth altitude criterion with high communication demands, particularly with the digital communication system. This was presumably due to the requirement to spend more time scanning the multi-function displays with the digital than with the verbal communication system. On the other hand, the pilots were less prone to task shedding when they used the digital communication system possibly due to the provision of a permanent list of queries that was unavailable with the verbal system. Measures of heart rate variability and blink rate were larger with the verbal than with the digital system, presumably reflecting increased respiratory demands in the verbal condition as well as increased visual processing demands with the digital format. Finally, the probe evoked P300 component decreased in amplitude as a function of increases in die magnitude of communications. The results are discussed in terms of the structural and capacity demands of the communications systems that were proposed for the advanced multi-function helicopter.     

Designing for transportation safety in the light of perception,attention, and mental models

Most recent research on error has concentrated on errors of planning, judgement, and action. This paper is concerned with errors in the acquisition of information which are caused by perceptual and attentional mechanisms. Failures to schedule attentional sampling of the environment will lead to accidents. Theoretical models exist for attention and for data acquisition. These models suggest how designers might approach human-machine systems so as to reduce error. A brief summary of the author's feelings about probabilistic risk assessment and related attempts to predict error is provided.     

Self-assessed changes in mental health and employment status as a result of unemployment training

The main question addressed in this article is: What factors in an unemployment programme serve both the individual and society? Our research focuses on background variables and process variables and how these can be assumed to affect certain dependent variables in unemployment training. The current focus is on the dependent variable "subjective assessment of the effect of the training on mental health", together with the more objective dependent variable of "employment status after training". Self-confidence, well-being, faith in the future, level of initiative and personal development have been used as indicators of self-assessed "mental health". Data were collected from an unemployment training programme in Sweden and the variables combined to create a hypothetical model. The model was statistically tested and then modified with the aid of LISREL statistics, which helps to adjust the model to statistical acceptance. The findings show that the salient factors directly related to the subjective assessment of the effect of training on mental health are gender, attitude to skills development, perceived training requirements and formal educational background. The latter relationship was negative. Of indirect importance are the level of commitment of the teacher, the satisfaction of the trainee with the process, and the level of control. The duration of previous unemployment was the only independent variable, which directly affected the employment status after the training, and this was in the negative direction. Of indirect importance for this dependent variable were training requirement, satisfaction with the process, own level of control and attitude to skills development.