TY - JOUR
T1 - Institutional decision-making to select patient care devices
T2 - Identifying venues to promote patient safety
AU - Keselman, Alla
AU - Patel, Vimla L.
AU - Johnson, Todd R.
AU - Zhang, Jiajie
N1 - Funding Information:
Support was provided in part by Grants P01 HS11544 and HS11806 from AHRQ. The authors give sincere thanks to the participants for their willing cooperation in this study. The authors also wish to thank the reviewers, including Mark Graham, for their insightful comments on the earlier version of the manuscript. Michal Tamuz from UT-Houston provided assistance with the development of the interview instrument.
PY - 2003
Y1 - 2003
N2 - Many medical errors that involve drug infusion devices are related to classic interface problems. Although manufacturers are becoming increasingly aware of human factors design considerations, many devices that are currently on the market are still sub-optimal for human use. This places significant responsibility for device selection on institutional purchasing groups. Theories of naturalistic decision-making point to many potential strengths and pitfalls of group decision-making processes that may affect the final outcome. This paper describes a retrospective analysis of decision-making process for infusion pump selection in a large hospital and focuses on factors related to patient safety. Through a series of detailed interviews and a study of relevant documentation we characterized the nature of the decision-making, patterns of communication, and the roles of different participants. Findings show that although the process involves a number of different professional groups and committees, the information flow among them is restricted. This results in inadequate representation of critical device usability considerations in the decision-making process. While all participants view device safety as an important consideration in the selection process, administrators (who are the final decision-makers) tend to equate safety with technical accuracy and reliability, paying less attention to the role of human factors in safe device use. Findings suggest that collaborative communication technology and automated evidence-based guidelines could provide support to institutional decision-making, ensuring that the process is efficient, effective, and ultimately safe for the patients.
AB - Many medical errors that involve drug infusion devices are related to classic interface problems. Although manufacturers are becoming increasingly aware of human factors design considerations, many devices that are currently on the market are still sub-optimal for human use. This places significant responsibility for device selection on institutional purchasing groups. Theories of naturalistic decision-making point to many potential strengths and pitfalls of group decision-making processes that may affect the final outcome. This paper describes a retrospective analysis of decision-making process for infusion pump selection in a large hospital and focuses on factors related to patient safety. Through a series of detailed interviews and a study of relevant documentation we characterized the nature of the decision-making, patterns of communication, and the roles of different participants. Findings show that although the process involves a number of different professional groups and committees, the information flow among them is restricted. This results in inadequate representation of critical device usability considerations in the decision-making process. While all participants view device safety as an important consideration in the selection process, administrators (who are the final decision-makers) tend to equate safety with technical accuracy and reliability, paying less attention to the role of human factors in safe device use. Findings suggest that collaborative communication technology and automated evidence-based guidelines could provide support to institutional decision-making, ensuring that the process is efficient, effective, and ultimately safe for the patients.
KW - Human factors design
KW - Institutional decision-making
KW - Patient safety
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U2 - 10.1016/S1532-0464(03)00055-8
DO - 10.1016/S1532-0464(03)00055-8
M3 - Article
C2 - 14552845
AN - SCOPUS:0141682553
VL - 36
SP - 31
EP - 44
JO - Journal of Biomedical Informatics
JF - Journal of Biomedical Informatics
SN - 1532-0464
IS - 1-2
ER -