Biomedical subjects

Ben-Tzion Karsh

Publications and source records attributed to Ben-Tzion Karsh.

9 recordsLinked to original sources

PubMed2006

Human factors engineering and patient safety.

The pediatric population has features different from those of adults and that are dynamic during the pediatric age range. Pediatric-specific issues result in potential risks for harm during medical care. Basic and applied human factors research has resulted in improvements in the performance of health adults and those adults who have functional limitations. Future work should focus on systematically understanding the human factors needs of children with the goal of redesigning systems of health care to optimize the safety of children and the performance of their care providers.

Age Factors↗

PubMed2006

Multiple user considerations and their implications in medical error reporting system design.

OBJECTIVE: The study examined the differences between physicians and clinical assistants in their preferences for a statewide medical error reporting system. BACKGROUND: Medical error reporting systems have been proposed as a means for studying the causes of medical error. Knowledge of user similarities and differences is needed for the development of design guidelines for medical error reporting systems. METHOD: Separate focus groups composed of 8 physicians and 6 clinical assistants (physician clinical support staff) were conducted. One-hour focus group meetings were conducted via toll-free teleconference lines one to two times per month for 9 months. All conversations were audiotaped and transcribed for analysis. An inductive content analysis was conducted. RESULTS: Eighty-six major and minor themes emerged. Differences between physicians and clinical assistants included rules and regulations governing the use of the system, the medium of reporting, and aspects of the organization that may affect reporting levels. CONCLUSIONS: Although physicians and clinical assistants shared similar preferences and beliefs surrounding error reporting, there were differences that need to be considered if medical error reporting systems are to be effective. APPLICATION: To successfully deploy a medical error reporting system, the system itself must be designed for the potential users. This study uncovered previously underappreciated issues that should be incorporated into the design and implementation process. Actual or potential applications of this research include the improvement of the design and implementation of medical error reporting systems to account for the needs of different types of users.

Attitude of Health Personnel↗

PubMed2005

Toward a theoretical approach to medical error reporting system research and design.

The release of the Institute of Medicine (Kohn et al., 2000) report "To Err is Human", brought attention to the problem of medical errors, which led to a concerted effort to study and design medical error reporting systems for the purpose of capturing and analyzing error data so that safety interventions could be designed. However, to make real gains in the efficacy of medical error or event reporting systems, it is necessary to begin developing a theory of reporting systems adoption and use and to understand how existing theories may play a role in explaining adoption and use. This paper presents the results of a 9-month study exploring the barriers and facilitators for the design of a statewide medical error reporting system and discusses how several existing theories of technology acceptance, adoption and implementation fit with many of the results. In addition we present an integrated theoretical model of medical error reporting system design and implementation.

Equipment Design↗

PubMed2005

Designing a technology enhanced practice for home nursing care of patients with congestive heart failure.

This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities. A modified macroergonomic analysis, design work system analysis, and focus groups utilizing participatory design methodology were undertaken to characterize the nursing practice model. Design of the HeartCare website required synthesizing the extant practice model and the agency's evidence-based heart failure protocols, identifying aspects of practice that could be enhanced by supporting technology, and delineation of functional requirements of the Enhanced HeartCare technology. Validation and refinement of the website and planning for user training activities will be accomplished through a two-stage usability testing strategy.

Community Health Nursing↗

PubMed2004

Evaluation of an intervention to reduce musculoskeletal hazards among fresh market vegetable growers.

OBJECTIVES: We conducted an intervention to convince small, fresh market vegetable operations to adopt mesh bags and standard containers, two production practices that aid in crop handling and that are known to improve labor efficiency and reduce exposures to musculoskeletal injury hazards. METHODS: The intervention disseminated information about the practices to growers through trade publications, public events, university Extension, and growers already using the practices. A mail questionnaire was administered to vegetable growers (n=243 and 207) before and after the intervention. Strawberry growers were used as a comparison group and also received questionnaires (n=50 and 35). RESULTS: After the intervention, more vegetable growers reported seeing information about mesh bags in trade publications (37% vs. 59%) and information about standard containers at public events (33% vs. 49%). Levels of self-reported adoption increased for containers (38% vs. 54%) and approached significance for bags (8% vs. 17%). Aware, non-adopting grower perceptions of bag profitability improved (2.6 vs. 3.8). Strawberry grower control results were unchanged. CONCLUSIONS: Better information flow to growers may be able to increase the speed with which agricultural practices with better ergonomics are adopted, especially when the practices are more profitable.

Agriculture↗

PubMed2004

Using variance analysis to detect hazards in a bar-code-assisted medication preparation process.

BACKGROUND: Medication errors have received significant attention, with studies pinpointing problems in the physician ordering, pharmacy dispensing, and nurse administering processes. Yet, the nursing process for preparing medications, which typically occurs in a medication room on the unit, has not received much attention. This process is deceptively complex, and without proper design, it could break down at numerous points. HUMAN FACTORS ENGINEERING ANALYSIS: Prospective hazard analysis methods allow the detection of potential hazards during the planning, assessment, and design phases of a process or technology. A specific technique-variance analysis-is used within one type of prospective hazard analysis, the sociotechnical systems analysis (STSA). STSA provides guidance to (1) analyze existing or planned systems to understand the social, technical, and environmental system components; (2) collect and analyze the system data; and (3) use the analysis to design or redesign the system. DISCUSSION: The STSA variance analysis is an additional tool that health care clinicians, administrators, and risk managers can use to proactively identify hazards for control. Although this larger analysis is more time consuming, it forces the analysts to conduct a true systems analysis before implementing technical, social, environmental, or organizational changes.

Analysis of Variance↗

PubMed2004

Design elements for a primary care medical error reporting system.

PROBLEM CONSIDERED: State and federal initiatives to develop medical error reporting systems are being proposed. For these to lead to an effective error reporting system to improve primary care, the needs of primary care professionals must be understood. METHODS: This study was based on the answers to key questions directed at primary care physicians and clinical assistants. A series of focus groups was held to determine what elements need to be included in the design of a medical error reporting system for ambulatory care. RESULTS: Participants addressed the purposes of an error reporting system, the barriers and motivators to the use of a system, the types of events that should be reported, how the reporting should be done, and how the data should be analyzed and used. During the sessions, 87 different themes emerged that were distilled down to the general principles and operating design elements deemed most important. CONCLUSIONS: The participating physicians and clinical assistants supported a primary care medical error reporting system designed to provide useful information to improve health care. The system should not be punitive.

Focus Groups↗

PubMed2004

Quality of work life of family physicians in Wisconsin's health care organizations: a WReN study.

PROBLEM CONSIDERED: Most family physicians in Wisconsin are employed by large health care organizations. Because of its impact on physician recruitment, retention, commitment to the organization, and patient care, the quality of physician work life is an important problem. METHODS: A survey was designed based on a literature review and augmented by focus group data. It was sent to all 1482 members of the Wisconsin Academy of Family Physicians in 2000. RESULTS: Overall response rate was 47%. Three hundred ninety-seven of the respondents were employed by 18 different health care organizations having 10 or more respondents. There were significant differences among Wisconsin's health care organizations in terms of physicians' satisfaction with their organization. There was a strong significant negative correlation between satisfaction with one's organization and turnover intention and a strong positive correlation between satisfaction with one's organization and ability to achieve one's professional goals. There were also significant, though less strong, correlations between satisfaction with one's organization and satisfaction with being a physician and perceived quality of care delivered. CONCLUSIONS: Some of Wisconsin's health care organizations are doing better than others at working with their family physicians to maximize these physicians' satisfaction with the organization, reduce the likelihood of turnover, and enable them to reach their professional goals.

Analysis of Variance↗

PubMedDate not supplied

Quality of work life of independent vs employed family physicians in Wisconsin: a WReN study.

PURPOSE: Family physicians in Wisconsin who are mainly employed by large health care organizations have voiced concerns regarding the quality of their work lives. We explored the quality of work life and its relationship to employment by health care organizations. METHODS: We conducted a cross-sectional survey of the 1,482 active members of the Wisconsin Academy of Family Physicians in 2000. RESULTS: A 47% overall response rate was obtained, and 584 respondents could be identified as independent or employed by a health care organization. There were no differences in age or sex between the 2 groups. The independent physicians worked longer hours, were in smaller work groups, and had been in practice longer and in their current practice longer than the employed physicians. Independent physicians reported better working relationships, more satisfaction with family time, more influence over management decisions, better satisfaction with being a physician, better perceived quality of the care they provided, greater ability to achieve professional goals, and lesser intention to leave the practice. CONCLUSIONS: Independent physicians have significantly more positive ratings of several aspects of the quality of their work life compared with physicians employed by health care organizations. Health care organizations need to address these issues if they are to have a satisfied and stable workforce.

Ambulatory Care Facilities↗