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Funeral workers (FWs) work within increasingly medicalized and commodified death-management systems. This study explored Worker Health and Safety (WHS) impacts in contemporary death management on Australian and Irish FWs. Mixed methods combined a survey and interviews. Survey data were descriptively summarized, interviews thematically analyzed, and a schematic systems model developed of the combined results. Survey participants (n = 45) reported psychosocial hazards from work pressures, competition, and fatigue. Psychosocial hazards were more frequently reported than physical hazards by Australian FWs. Physical hazards were of greater concern to Irish FWs. Themes from 11 interviews were: Personal Attributes, Work Demands, and Socio-Cultural Context. All FWs reported conflicts between individual capacities, work demands, and resources, resulting in hazardous personal states including difficulty sleeping and stress. Respectfully manually handling human remains and "event management" demands for increasingly elaborate funerals created negative WHS impacts. This research informs risk management for FWs and other workers in the increasingly complex death-care industry. [ABSTRACT FROM AUTHOR]

Emergency department (ED) disposition decision-making represents a critical juncture in patients’ care journeys, as it shapes the type of care patients access following an ED visit. However, there is a dearth of information related to how and in what context the disposition decision-making occurs. We conducted a scoping review to synthesize what previous studies reveal about the ED work system elements that influence disposition decision-making. A dual-coding screening process identified 27 articles from database searches. Articles were extracted and analyzed using the Systems Engineering Initiative for Patient Safety model. Most articles included at least two work system components. Our results suggest that the literature captures only some of the complexity of disposition decision-making, leaving certain elements underexplored or limited in scope. This review identifies informational gaps that, if addressed by future research, will support ED system redesigns that optimize patient, clinician, and organizational outcomes.

Abstract Background Like most hospitals, our hospital experienced COVID-19 pandemic-related supply chain shortages. Our additive manufacturing lab’s capacity to offset these shortages was soon overwhelmed, leading to a need to improve the efficiency of our existing workflow. We undertook a work system analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) construct which is based on human factors and quality improvement principles. Our objective was to understand the inefficiencies in project submission, review, and acceptance decisions, and make systematic improvements to optimize lab operations. Methods Contextual inquiry (interviews and workflow analysis) revealed suboptimal characteristics of the system, specifically, reliance on a single person to facilitate work and, at times, fractured communication with project sponsors, with root causes related to the project intake and evaluation process as identified through SEIPS tools. As interventions, the analysis led us to: 1) enhance an existing but underused project submission form, 2) design and implement an internal project scorecard to standardize evaluation of requests, and 3) distribute the responsibility of submission evaluation across lab members. We implemented these interventions in May 2021 for new projects and compare them to our baseline February 1, 2018 through – April 30, 2021 performance (1184 days). Results All project requests were submitted using the enhanced project submission form and all received a standardized evaluation with the project scorecard. Prior to interventions, we completed 35/79 (44%) of projects, compared to 12/20 (60%) of projects after interventions were implemented. Time to review new submissions was reduced from an average of 58 days to 4 days. A more distributed team responsibility structure permitted improved workflow with no increase in staffing, allowing the Lab Manager to devote more time to engineering rather than administrative/decision tasks. Conclusions By optimizing our workflows utilizing a human factors approach, we improved the work system of our additive manufacturing lab to be responsive to the urgent needs of the pandemic. The current workflow provides insights for labs aiming to meet the growing demand for point-of-care manufacturing.

This paper explores the development of two theories of human behavior as they relate to work systems. Both Murray Bowen and Barry Oshry formulated theories of how people operate in groups. Bowen developed his theory through observation of families and extended his thinking to apply more broadly. Oshry observed work systems in his lab and thought what he saw there could also be true in families and society at large. Practitioners have applied both theories in their work with groups. However, neither theory has received much attention in terms of the theoretical concepts they contain or the processes the theoreticians used to generate them. The purpose of this paper is to examine the methods these two theorists use to create their frameworks, compare and contrast the theories they posited as a result, and consider the possible future development for them. [ABSTRACT FROM AUTHOR]

Workarounds are deviations in the execution of designed, de jure, work processes. Process mining research has developed methods for unobtrusive workaround analysis using process-aware systems’ datasets. This study applies process mining for workaround analysis in a medium-sized enterprise (SME). SME contexts can be challenging for workaround mining because SMEs often lack de jure process designs and their process-supportive information systems may have ambiguous semantics. The identification of de jure models and the solving of systems data ambiguities are the first steps in workarounds identification. A semantically well-defined information system may enable factual, de facto, process mining. Comparing the de jure and de facto process models may give candidate workarounds. Our study shows that (1) incomplete de jure models hinder the use of process mining for detecting workarounds, and (2) human interpretation of process mining outcomes is needed to realize a useful triple loop organizational learning from workarounds mining.

Background: Like most hospitals, our hospital experienced COVID-19 pandemic-related supply chain shortages. Our additive manufacturing lab's capacity to offset these shortages was soon overwhelmed, leading to a need to improve the efficiency of our existing workflow. We undertook a work system analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) construct which is based on human factors and quality improvement principles. Our objective was to understand the inefficiencies in project submission, review, and acceptance decisions, and make systematic improvements to optimize lab operations. Methods: Contextual inquiry (interviews and workflow analysis) revealed suboptimal characteristics of the system, specifically, reliance on a single person to facilitate work and, at times, fractured communication with project sponsors, with root causes related to the project intake and evaluation process as identified through SEIPS tools. As interventions, the analysis led us to: 1) enhance an existing but underused project submission form, 2) design and implement an internal project scorecard to standardize evaluation of requests, and 3) distribute the responsibility of submission evaluation across lab members. We implemented these interventions in May 2021 for new projects and compare them to our baseline February 1, 2018 through – April 30, 2021 performance (1184 days). Results: All project requests were submitted using the enhanced project submission form and all received a standardized evaluation with the project scorecard. Prior to interventions, we completed 35/79 (44%) of projects, compared to 12/20 (60%) of projects after interventions were implemented. Time to review new submissions was reduced from an average of 58 days to 4 days. A more distributed team responsibility structure permitted improved workflow with no increase in staffing, allowing the Lab Manager to devote more time to engineering rather than administrative/decision tasks. Conclusions: By optimizing our workflows utilizing a human factors approach, we improved the work system of our additive manufacturing lab to be responsive to the urgent needs of the pandemic. The current workflow provides insights for labs aiming to meet the growing demand for point-of-care manufacturing. [ABSTRACT FROM AUTHOR]

With ubiquitous, mobile computing, health care systems, and smart factories, socio-technical phenomena continue to emerge that challenge traditional design and evaluation methods. We perceive such phenomena as the intertwinement of technical artifacts and social practices. Previous work shows that there is no sufficient method to evaluate the quality of this socio-technical intertwinement. Hence, our goal was to develop socio-technical heuristics, in short ST-heuristics, that can be applied by individuals to detect issues. Drawing inspiration from the success of usability heuristics in the field of human–computer interaction, we first applied a literature review to develop an initial set of ST-heuristics derived from six domains comprising groupware/computer-support cooperative work, job design, usability, socio-technical design principles, privacy, and process design. We then conducted two studies to evaluate and improve this set using empirical data from 13 cases from health care, industry, and engineering education fields. In total, we analysed 306 problems. The results substantiate a final set of eight ST-heuristics which allow for evaluating the socio-technical intertwinement in situ. We perceive the contribution of this work as a starting point for evaluators to uncover crucial issues and to improve current practice. We discuss the developed set of ST-heuristics within existing literature. [ABSTRACT FROM AUTHOR]

Purpose: To examine High-Performance Work Systems (HPWS) as a framework for academic development, work environment, and promotion among faculty in higher education. Design/methodology/approach: A mixed-methods approach that employed both quantitative tools with an administered survey and quali-tative interactions using the interview process was used. Participants were recruited using a systematic and random sampling approach of faculty in Thailand and selected international institutions. Findings: Four hundred and sixty-three participants, including 236 from Thailand and 227 from international institutions, completed the survey with 20 participants from each of Thailand and international insti-tutions involved in interviews. HPWS as a theoretical framework in the academic environment was associated with academic development and promotion (p<0.001). Differences were identified in the performance indicators and promotion criteria between Thailand and international participants. Social inequality, disproportionate administrative decision-making, and wellness towards promoting a healthy work and life balance emerged as central themes. Practical implications: Study findings consistent through comparative literature, statistical testing, and saturation of inter-view responses revealed that HPWS as a theoretical framework in human resource management ap-plies to academic development and promotion experiences in higher education. Originality/value: The paper could continue the evaluation and application of HPWS as a human resource framework towards the mutual benefit of performance and promotion of faculty and higher education institutions. [ABSTRACT FROM AUTHOR]

This paper explores the development of two theories of human behavior as they relate to work systems. Both Murray Bowen and Barry Oshry formulated theories of how people operate in groups. Bowen developed his theory through observation of families and extended his thinking to apply more broadly. Oshry observed work systems in his lab and thought what he saw there could also be true in families and society at large. Practitioners have applied both theories in their work with groups. However, neither theory has received much attention in terms of the theoretical concepts they contain or the processes the theoreticians used to generate them. The purpose of this paper is to examine the methods these two theorists use to create their frameworks, compare and contrast the theories they posited as a result, and consider the possible future development for them.

This study examines the performance of cognitive work—as constrained by physical, policy and resource-related factors—in the near-simultaneous design and execution of disaster response operations. The demands of the situation described here—the removal of debris from a high-value barrier island in the US state of New York after Hurricane Sandy (2012)—lay at the far boundaries of the responding organizations' experience, making this case an excellent candidate for study. Data are analyzed on the deliberative processes of the responding organization in order to characterize the interaction between the design and operation of the debris removal network over time. Statistical data modeling of these processes reveals a number of temporal dependencies between ideation and decision-making processes, as well as between components of the system. The illumination and quantification of these processes using data produced through normal operations contributes significantly to theories of the cognitive and behavioral phenomena that underlie organizational response to highly non-routine events, thus building upon broader theories of organizational improvisation and performance. [ABSTRACT FROM AUTHOR]

In an attempt to maintain competitiveness, more and more firms are moving towards business models that integrate equipment, goods and services, such as in a product-service system (PSS), with a view to delivering value. This transition requires a shift in business thinking for developing arrangements to provide integrated product-service (PS) offerings that are sustainable, technical and/or marketable. The aim of this article is to offer insights into work systems for providing integrated PS offerings by competitive firms. It adopts ‘work system theory’ as a research lens and an inductive multiple-case logic consisting of an in-depth exploratory study of four competitive micro-engineering firms, to capture ‘what’ and ‘how’ information and service systems contribute to the sustainability, technical and marketability themes for competitiveness using PSSs. The article finds that technical requirements of competitive PSSs are best fulfilled in work systems that emphasise individual timeliness/ buy-ins, synchronous communications managed by strategic roles and tie-ins offered by service contracts. The study also revealed an emphasis, by the case firms, on relationship building and policy implementation for achieving PSS marketability and sustainability, respectively. [ABSTRACT FROM PUBLISHER]

The aim of current study is to identify what visions those students are expecting to graduate and soon enter the labor market have regarding work systems in the light of changes in Omani society. It also aims to investigate the compatibility of these visions with modern work requirements. A questionnaire, containing qualitative and quantitative questions, was distributed among (230) students (both males and females) who expected to graduate in 2013. Results showed that participants agreed that job advertisement must include job title, financial degree, and its requirements. In addition, work systems must respect society’s traditions, provide appropriate specialization, provide training for staff according to an annual plan, allow overtime during working days or holidays, double overtime work wage, and avoid preference in work wage according to gender, race, or religion. Results also showed that more than half of the study sample prefers working in the public sector rather than the private sector or entrepreneurship, and there is a duality in students’ visions regarding work systems between traditional orientations and modern orientations.

A survey of human factors practitioners working in health care was administered to understand their challenges and successes encountered when responding to the COVID-19 pandemic. Focus areas identified by survey respondents related to workflow, physical environments, communication, and implementation of new technologies. The results from this study can be used by human factors practitioners to demonstrate the common challenges and opportunities for applying human factors to system redesign within their health care organizations. These findings can also be used to encourage investments in human factors by health care organizations and the federal government. [ABSTRACT FROM AUTHOR]

A number of studies have demonstrated visual schedules and work systems to be effective in assisting students on the autism spectrum to stay on task and work independently. However, evidence of effectiveness does not ensure a timely implementation of interventions in applied educational contexts. The translatability of interventions depends, to a large extent, on their contextual fit and how they are perceived by those that will use them. This mixed methods study examined general education teachers' responses to an information toolkit outlining the use of visual schedules and work systems as inclusive, whole-class practices. While teachers regarded the toolkit positively, their responses also offer insights into potential barriers to implementation. [ABSTRACT FROM AUTHOR]

Developing skills for functional independence is important to gain employment, engage in postsecondary education, and live independently. Unfortunately, individuals with autism spectrum disorder (ASD) experience difficulties with functional independence skills needed to complete common, everyday tasks. This study examined the effects of work systems to increase independent task initiation and completion of tasks in home settings completed by three adolescents with ASD. The work systems were implemented by parents. Results indicated parent-implemented work systems are effective at increasing the task initiation and completion of everyday tasks, completed by adolescents with ASD. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) are a risk factor for hospital-acquired Clostridium difficile infection (CDI). Much PPI use is inappropriate, and interventions to reduce PPI use, such as for stress ulcer prophylaxis in all critically ill patients, are essential to reduce CDI rates. This mixed-methods study in a combined medical-surgical intensive care unit at a tertiary academic medical center used a human factors engineering approach to understand barriers and facilitators to optimizing PPI prescribing in these patients. We performed chart review of patients for whom PPIs were prescribed to evaluate prescribing practices. Semistructured provider interviews were conducted to determine barriers and facilitators to reducing unnecessary PPI use. Emergent themes from provider interviews were classified according to the Systems Engineering Initiative for Patient Safety model. In our intensive care unit, 25% of PPI days were not clinically indicated. Barriers to optimizing PPI prescribing included inadequate provider education, lack of institutional guidelines for stress ulcer prophylaxis, and strong institutional culture favoring PPI use. Potential facilitators included increased pharmacy oversight, provider education, and embedded decision support in the electronic medical record. Interventions addressing barriers noted by front line providers are needed to reduce unnecessary PPI use, and future studies should assess the impact of such interventions on CDI rates. [ABSTRACT FROM AUTHOR]

The specialty referral process consists of primary care clinicians referring patients to specialty consultants. This care transition requires effective care coordination and health information exchange between care teams; however, breakdowns in workflow and information flow impede "closing the referral loop" and delay or prevent referrers from receiving the consultant's "visit notes," particularly in cross-institutional referrals. This study aimed to describe and map the referral process as it occurs in clinics and identify and characterize work system barriers affecting its performance. Referrers and consultants were interviewed about their perceived workflows, barriers, and clinical outcomes to inform a workflow analysis. • Hidden, nested operational processes are critical to "closing the referral loop.". • Barriers were most commonly associated with technology and organizational factors. • Updated clinician directories and meaningful notifications could reduce barriers. • Locus of responsibility for the information exchange to close the loop is ambiguous. [ABSTRACT FROM AUTHOR]

Background: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation., Objective: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct understanding of an emergency department-based CDS tool to prevent future falls and identifying factors impacting clinicians' use of the tool through an analysis of the resultant qualitative data., Methods: Previously, our team designed a CDS tool to identify patients aged 65 years and older who are at the highest risk of future falls and prompt an interruptive alert to clinicians, suggesting the patient be referred to a mobility and falls clinic for an evidence-based preventative intervention. We conducted 10-minute academic detailing interviews (n=16) with resident emergency medicine physicians and advanced practice providers who had encountered our CDS tool in practice. We conducted an inductive, team-based content analysis to identify factors that influenced clinicians' use of the CDS tool., Results: The following categories of factors that impacted clinicians' use of the CDS were identified: (1) aspects of the CDS tool's design (2) clinicians' understanding (or misunderstanding) of the CDS or referral process, (3) the busy nature of the emergency department environment, (4) clinicians' perceptions of the patient and their associated fall risk, and (5) the opacity of the referral process. Additionally, clinician education was done to address any misconceptions about the CDS tool or referral process, for example, demonstrating how simple it is to place a referral via the CDS and clarifying which clinic the referral goes to., Conclusions: Our study demonstrates the use of academic detailing for supporting the implementation of health information technologies, allowing us to identify factors that impacted clinicians' use of the CDS while concurrently educating clinicians to ensure the correct understanding of the CDS tool and intervention. Thus, academic detailing can inform both real-time adjustments of a tool's implementation, for example, refinement of the language used to introduce the tool, and larger scale redesign of the CDS tool to better fit the dynamic work environment of clinicians., (©Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 18.04.2024.)

Despite efforts to prevent health care–associated infections (HAIs), these infections continue to challenge health care systems. The Centers for Disease Control and Prevention emphasizes implementation of evidence-based practices. Within the complex health care environment, sustained implementation calls for work systems that harness expertise of interprofessional teams, which, in turn, calls for suitable executive, mid-level, and local leadership. The purpose of this review is to highlight the need to study leadership when using a systems approach to reduce HAIs. This is a scoping review of HAI studies that used a systems engineering model called the Systems Engineering Initiative for Patient Safety model. We examined if and how leadership was addressed within 1 systems approach. We found 15 studies using the Systems Engineering Initiative for Patient Safety model and, of these, leadership was directly mentioned in 3 studies. In the remaining studies, reference to leadership may be inferred by use of terms such as teamwork, managerial oversight, climate and culture, staffing support, and institutional/administrative support. Research is needed to bring recognition of the role of leadership within a work systems approach to reducing HAIs. We need further examination of leadership attributes and communication behaviors that allow staff to diffuse and sustain best practices to prevent HAIs. [ABSTRACT FROM AUTHOR]

Apparent differences in executive function can lead to challenges for students on the autism spectrum in mainstream settings. Difficulties with staying on‐task and transitioning between tasks and task elements can interfere with students’ participation in educational activities and lead to stress and anxiety. While the use of visual supports, such as visual schedules and work systems, has been shown to be effective in supporting students to stay on‐task in special education and autism‐specific settings, there is little research to support the use of these strategies by teachers in mainstream classrooms. This study evaluated the use of visual schedules and work systems in supporting four students on the autism spectrum to stay on‐task and work independently in a mainstream setting. These strategies were implemented by teachers as inclusive practices, and evaluated using observations within the natural classroom environment to examine their feasibility in mainstream settings. All participants demonstrated improvements in on‐task behaviours. Results for other, secondary, dependent variables were mixed, with some students showing reduced off‐task behaviours and increased productivity. The implications for clinical practice and future research directions are discussed. [ABSTRACT FROM AUTHOR]