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IOE 899: Seminar in Industrial and Operations Engineering
Wed Nov 11, 2009, 4:00-5:00pm, 1680 IOE

Jenna Marquard, University of Massachusetts
"Efficiency, Thoroughness, and the Patient Identification Process"

Abstract
The main objective of this study was to develop and test a methodology, based on the efficiency-thoroughness trade-off (ETTO) principle, to evaluate whether and how health care workers balance efficiency and thoroughness while completing patient care tasks. Health care workers’ abilities to complete patient care tasks in a timely manner is essential for the provision of safe care, as untimeliness can result in care provided too late or not at all. Additionally, health care workers’ thoroughness in completing tasks is paramount to providing safe care, as workers play a key role in preventing and intercepting medical errors. This talk details the proposed methodology and tests its effectiveness by attending to one vital health care process (verifying a patient’s identity) in a complex yet critical subsystem of the health care system (the Emergency Department). Patient identification errors – a topic of national interest – are a root cause of medication, surgical, charting, dietary, and other medical errors. Research shows patient identification errors are relatively common, providers are not good at noticing identification errors, and the failure to correctly identify a patient can result in serious subsequent errors. Study researchers observed emergency department (ED) employees (N=61) as they completed three common patient-related tasks in a simulated patient care space while wearing an eye tracking device. Each HCW performed a common patient care task on three researchers acting as patients, with one patient having an incorrect identity. The results of the study show that workers who detected the identification error were less efficient in completing the process than workers who did not detect the error. Additionally, this talk describes why some workers fail while following well-defined standard processes, where others succeed while following non-standard processes. The ETTO principle is a useful mechanism to understand why some health care workers detect patient identification errors and why others do not. The approach described in this paper can be extended to empirically test how individuals detect and mediate other types of medical errors. Based on the findings of this study, and coupled with existing literature, identifying within-group differences related to individuals’ efficiency levels and ability to detect identification errors will guide more thoughtful job design interventions.
 
Bio
Jenna L. Marquard is an Assistant Professor of Industrial Engineering at the University of Massachusetts Amherst. She oversees the Decision-Making and Behavior Lab at UMass, and seeks to understand how individuals' characteristics influence their decision-making and behavior, to better guide the design of: * Things (e.g. tools and technologies) * Processes * Policies * Communication and Conveyance Strategies The majority of her research focuses on healthcare consumer and provider decision-making and behavior.

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