Applying Human Factors/Ergonomics to support change in healthcare - An innovative co-designed approach to conducting antibiotic allergy de-labelling in the intensive care unit
本研究展示了如何运用人因工程学方法，通过系统分析、协同设计等步骤，在重症监护室成功为85名患者清除不准确的抗生素过敏标记，为医疗变革提供可借鉴的结构化路径。
Implementing change in complex healthcare systems is inherently difficult, with most change initiatives failing. Human Factors/Ergonomics can support change processes through better understanding of the current system and designing and implementing new improved ways of working. One in four patients have a documented antibiotic allergy. Inaccurate and unverified antibiotic allergy labels have a negative impact on patient outcomes. The authors have been involved in the successful introduction of a new approach to allergy de-labelling in the intensive care unit. The primary objective of this study was to outline how this change was supported by applying Human Factors/Ergonomics to the change process. The Cube socio-technical systems analysis was used to understand and support this complex change across four domains of culture, system functioning, action and sensemaking and across a change cycle of understanding the current ‘as is’ problem; co-designing the ‘to be’ solution; planning and preparing to change; implementing and embedding the change. Over the course of the study 85 patients with either a reported non-immune or low risk antibiotic allergy were successfully de-labelled. This study exemplifies Human Factors/Ergonomics in action and has shown that taking a structured approach to change, that aims to understand and alter different system components, can achieve results. • Adopting a Human Factors/Ergonomics based approach to successful change in healthcare has shown promise. • In this study HFE was used to support the successful de-labelling of patients with inaccurate allergy labels. • More than half of hospitalised patients receive at least one antibiotic, while one in four have a documented allergy. • Inaccurate and unverified antibiotic allergy labels have a negative impact on patient outcomes. • Over the course of the study 85 patients were successfully de-labelled in the intensive care unit.