Using Human factors approach to evaluate patient-centered cancer care
Authors: Safa Elkefi, Onur Asan, Tina W F Yen
Abstract: Patient-centered care (PCC) approaches are critical for the delivery of high-quality care in cancer care where the therapeutic alliance between patients and the oncologists is frequent over extended periods of time. The concept of patient-centered care has received increased attention since the publication of the 2001 Institute of Medicine (IOM) report Crossing the Quality Chasm. In this study, we create and evaluate a new framework for patient-centered care in cancer using human factors approaches. Many initiatives focused on developing technologies that help foster PCC by increasing patients’ access to information and facilitating self-monitoring and patient convenience. This paper makes an important contribution to the literature by historically examining the evolution of the definitions of care approaches from disease-centered care focusing on curing the diseases to patient-centered care satisfying patients’ needs to person-centered care. Instead of treating people like victims of diseases, this model recognizes their need for more than one professional to support them emphasizing their capabilities and potential to improve their own health by themselves. It also provides a different and complementary way to the visit-oriented approach furnishing more accessible and continuous care over time, Our contribution also covers summarizing the existing measures adopted to measure its components and finally suggests a socio-technical framework based on the human factors approach to measuring PCC effectiveness. Our approach to measuring PCC is grounded in the conceptual framework we are suggesting that evaluates the effectiveness of patient-centered care based on a socio-technical perspective. We link the cognitive perception of patients towards PCC (Cognitive Sensory Input) to their exposure to external factors (Exposure) that may affect their (Cognition) behavior. A holistic approach recognizing health care as a dynamic socio-technical system in which sub-elements interact with each other remains necessary to better understand the system and its constraints in cancer care. We use a case study to emphasize the importance and need of such a human factors-based framework in providing a better quality of care and improving health outcomes. Achieving high-quality care is a complex pursuit in any setting especially for cancer care and improving the patient journey requires an integrated system of care and productive interactions among many system levels. By understanding the work system components, the design and integration of tasks, technology, and clinical processes can be reviewed to better support the respective needs of individuals while optimizing system performance. A supportive work environment and a highly engaged workforce are highly correlated with improved quality of patient-centered care and hospital performance. At the population level, case managers, navigators, quality officers, and administrators may track outcomes across patients.This framework can help organize clinical interventions that aim to control cancer patients’ behavior from a patient-centered perspective. It can also help technology designers by giving them insight into how patient-centeredness in the design of health informatics can impact cancer patients’ behavior. In addition, patient-centered designs can enhance technology acceptance among cancer patients making it easier to adopt technology for follow-up reasons by involving human factors and ergonomics principles in order to ensure successful results.
Keywords: Human Factors, Systems Engineering, Patient-centered care, Person-centered care, cancer care, Systems Interaction, Healthcare Management
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