A Participatory Ergonomics Approach to Healthcare System Redesign: The Case of Family-Centered Rounds in a Pediatric Hospital

Healthcare systems are in great need of redesign to provide care that is safe and effective. Human Factors and Ergonomics (HFE) is a key systems engineering approach to healthcare system redesign. Participatory ergonomics (PE) can promote the application of HFE to healthcare system redesign. However, limited empirical knowledge is available on the use of PE to redesign complex healthcare processes. A challenge of PE application to redesigning complex healthcare processes is to involve multiple stakeholders with different perspectives in the redesign process. The objectives of this study are: (1) to provide empirical knowledge about how PE can be applied to redesign complex healthcare process, and (2) to examine the experience of different groups of stakeholders regarding their collaboration in the redesign process.;This study is based on a large research project, which aims to redesign the family-centered rounds (FCR) process to improve family engagement at the American Family Children's Hospital in Madison, Wisconsin. A case study is presented to describe how different stakeholders in FCR were involved in the redesign process, and how HFE principles were used in the content and process of the redesign. Semi-structured face-to-face interviews were conducted with ten stakeholder representatives participating in FCR redesign to explore their experience with collaboration. A model of collaborative healthcare system redesign was developed. The collaborative redesign process consists of four phases: setup of the redesign team, preparation for meetings, collaboration in meetings, and follow-up with meetings. Outcomes of the collaborative redesign process include team outcomes and redesign outcomes. Work system facilitators and barriers to collaboration and challenges associated with the participation of multiple stakeholders were also identified.;The findings of this study are expected to contribute to knowledge about PE application, and to facilitate future healthcare system redesign efforts. Future research needs to (1) validate the model of collaborative redesign by conducting more case studies in various contexts, (2) demonstrate the value of PE in healthcare system redesign by assessing the impact of the redesign on the FCR process and patient outcomes, and (3) conduct more empirical studies to show how HFE can be applied to healthcare system redesign.