Applied ergonomics
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Physicians' work schedules are an important determinant of their own wellbeing and that of their patients. This study considers whether allowing physicians control over their work hours ameliorates the effects of demanding work schedules. ⋯ For participants who never worked long shifts, work time control was associated with fewer short sleeps, but this was not the case for those who did work long shifts. Optimizing the balance between schedule flexibility and patient needs could enhance physicians' sleep when working the night shift, thereby reducing their levels of fatigue and enhancing patient care.
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Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in "patient-engaged human factors," or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. ⋯ Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains-physical-spatial, social-cultural, and organizational-and multiple "spaces" such as "at home," "on the go," and "in the community." Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, contexts, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work.
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This exploratory research aims to understand how teams organize themselves and collectively manage risky dynamic situations. The objective is to assess the plausibility of a model of a collective trade-off between "understanding" and "doing". The empirical study, conducted in the pediatric anesthesia service of a French university hospital, was supported by a "high fidelity" simulation with six teams. ⋯ These modes are related to the way in which teams manage their cognitive resources. More precisely, they are related to the teams' ability to collectively elaborate a trade-off between "understanding" and "doing". These results question existing perspectives on safety and suggest improvements in the design of crisis management training (concerning for example the recommendation of "calling for help").