Workarounds are idiosyncratic solutions to perceived blocks in work flow. While they are widely acknowledged by health care professionals, there remains relatively little research on the impact that they have on health care professionals and patients. This talk summarizes a AHRQ- and NIOSH-funded stream of research examining how workarounds influence patient safety and nurse safety and occupational health. Through both quantitative and qualitative research designs, our research echoes significant concerns about patient safety from the literature, particularly in the medication process. Moreover, our research extends the literature by finding that workarounds can also lead to high levels of stress and increase risk of occupational injuries for nurses. In addition to sharing our findings, I discuss the implications of our findings for work design and patient safety.

Matthew Weinger, MD, provides an overview of 15 years of human factors research on point-of-care work processes in the medical domain, primarily in anesthesiology. Research projects to be discussed include field observations, device evaluations, and controlled studies in both real and simulated care environments. Methods for the conduct of task analysis, workload assessment, and event analysis will be emphasized.

Significant attention is being paid to translational research applied to health care – both clinically and administratively. In this lecture, Hundt presents an overview of translational research and the impact human factors engineering translational research can have in affecting change in health care, specifically applied to HIT. Experience from two HIT-related grants in which both prospective risk analysis and usability evaluation methods were incorporated will be discussed.

Paul Micheli and Julie Mills are Usability Engineers at GE Healthcare in their anesthesia and ventilator division. They discuss how they take in account patient safety initiatives in their user interface design work. The focus is the importance of good user interface designs for anesthesia and ventilator devices.

Michael O'Neil, PhD, addresses the importance of a "user-centered" approach to design and management of healthcare environments. Users include patients, visitors and staff. This presentation asserts that assessment of healthcare facility quality must go beyond existing (important) measures of patient health outcomes, and include the impact of design of space on the quality of the user experience. A Six-Sigma based approach to implementing user-centered quality measures is then discussed. O'Neil's current research on Cancer Treatment Centers will also be briefly addressed.