| This research is designed to better understand health care work by systematically capturing and characterizing patient care in hospital emergency departments. The patient-oriented methodology, specifically designed to allow researchers and practitioners to characterize patient care by using the concept of workflow, was developed and tested. This new approach has a different perspective than the commonly utilized clinician-oriented workflow approach. This thesis proposes to organize the study of workflow not from the perspective of the worker, but oriented around the patient, the focus of work.;A non-experimental observation study was conducted to evaluate the patient-oriented workflow methodology in three non-academic urban hospital emergency departments. A hundred and eight patient care episodes were observed until the first patient driven order by using a structured data collection tool. The focus was on sequence of activity role pairs. The wide spectrum of these episodes provides evidence of the validity, viability and reliability of the methodology.;A three step data analysis was utilized: descriptive statistics, visualization and cluster analysis. The results highlighted the variability of workflow across patient care episodes. However, the data also suggests six main sequence patterns. The patient oriented workflow methodology allowed characterization of patient care in terms of sequences of involving activity-role pairs and revealed important features that should be considered to understand work in complex environments.;This study contributes research in industrial engineering by introducing a new approach to capture actual patient care episodes and model the workflow in emergency departments. Understanding patient care episodes in situ provides a better understanding of cooperative work and informs work interventions that aim to improve the efficiency of patient care delivery and affect work of multiple roles. The patient oriented workflow methodology can provide a useful perspective to researcher and practitioner to examine the quality, efficiency and safety of care by enhancing our knowledge on cooperative work takes place in clinical settings. |
