Bypassing the Emergency Department: Using human factors and systems thinking to identify the consequences of hospital adaptation

E. Austin1, A. De Los Santos2, P. Salmon3, and R. Clay-Williams1

1 Australian Institute of Health Innovation, Macquarie University, Sydney, Australia

2 Western Sydney Local Health District, Sydney, Australia

3 Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sunshine Coast, Australia

 

HUMAN FACTORS AND SYSTEMS THINKING
Care is a product of the interactions between the many people, departments and technologies within the hospital system.

DATA COLLECTION
ED Bypass model of care governance documents were reviewed and data was extracted. Interviews with ED staff.

SYSTEMS ANALYSIS
The Cognitive Work Analysis Framework was used to explore in detail the who, what, where, when, and how the new model of care work was performed in ED, how the new Bypass processes interfaced with normal ED work-as-done and how it resolved the unintended consequence of the surgical streamline process

OUTCOMES
• Enhanced patient flow within the department
• Improved access to specialised community services
• Efficient and prompt access to care
• Improving patient experience and outcomes
• Meeting the department performance indicators

IMPACT
Successful, but…