title: Macroergonomics in Healthcare Quality and Patient Safety.
abstract: The US Institute of Medicine and healthcare experts have called for new approaches to manage healthcare quality problems. In this chapter, we focus on macroergonomics, a branch of human factors and ergonomics that is based on the systems approach and considers the organizational and sociotechnical context of work activities and processes. Selected macroergonomic approaches to healthcare quality and patient safety are described such as the SEIPS model of work system and patient safety and the model of healthcare professional performance. Focused reviews on job stress and burnout, workload, interruptions, patient-centered care, health IT and medical devices, violations, and care coordination provide examples of macroergonomics contributions to healthcare quality and patient safety. Healthcare systems and processes clearly need to be systematically redesigned; examples of macroergonomic approaches, principles and methods for healthcare system redesign are described. Further research linking macroergonomics and care processes/patient outcomes is needed. Other needs for macroergonomics research are highlighted, including understanding the link between worker outcomes (e.g., safety and well-being) and patient outcomes (e.g., patient safety), and macroergonomics of patient-centered care and care coordination.
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Ben-Tzion
authors.initials: BT
authors.lastname: Karsh
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Ayse P
authors.initials: AP
authors.lastname: Gurses
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Richard
authors.initials: R
authors.lastname: Holden
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Peter
authors.initials: P
authors.lastname: Hoonakker
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Ann Schoofs
authors.initials: AS
authors.lastname: Hundt
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Enid
authors.initials: E
authors.lastname: Montague
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Joy
authors.initials: J
authors.lastname: Rodriguez
authors.affiliation: University of Wisconsin-Madison. Johns Hopkins University. Northwestern University. Clemson University. Vanderbilt University.
authors.forename: Tosha B
authors.initials: TB
authors.lastname: Wetterneck
keywords: SEIPS model; care coordination; healthcare quality; interruptions; job stress; macroergonomics; mixed methods research; organizational context; patient safety; patient-centered care; sociotechnical system; system design; work system; workload
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