Presentation
HE2 - Applying a Sociotechnical Systems Approach to Identify Risk and Support Health and Well-Being of the Healthcare Workforce
DescriptionBackground: Worker health efforts have traditionally focused on isolated components of the worker, work, and workplace to enhance worker wellness. A sociotechnical systems approach to understanding the work system can help identify risks and support worker health. Sociotechnical systems recognize the interrelatedness of the technical and social components of the workplace, and the need to optimize both aspects to provide a high-quality and satisfying work environment for workers within these systems. Such a view allows for the acknowledgment of relationships, interactions, and components of the system that lead to worker health outcomes. One high-risk healthcare worker population is sonographers. Various methods have been implemented to support worker health in sonographers, including improving poor equipment design, increasing worker training, and developing workplace guidelines. However, work-related health discomfort remains an issue, with prevalence rates of negative work-related health outcomes as high as 85-95%.
Methods: The Systems Engineering Initiative for Patient Safety (SEIPS) framework is one of the leading sociotechnical systems models that provides a useful foundation for identifying these critical factors. Although the worker is included as a component of the work system within the SEIPS model, this model primarily focuses on patient safety and organizational-level outcomes. Using the SEIPS as a foundational framework, we developed the Sonography Work Systems (SWS) model to focus on worker health and well-being outcomes that then influence the system with the sonographer located at the center of the critical relationships among the work systems factors and the performance of work processes. To examine the utility of our SWS model, we conducted a national workforce survey to explore associations among personal, physical, social, and organizational work system factors and sonography work processes with worker health outcomes.
Results: Using logistic regression analyses, we identified associations and interactions between the worker-work-workplace system components within a representative sample of 3659 sonographers. In our sample, 86% of sonographers reported work-related discomfort, and nearly half of the sample reported regularly experiencing headaches and visual strain associated with their work. Multiple work systems factors contributed to a final model of protection from physical discomfort, including using adjustable equipment, regularly taking work breaks, having a positive workplace culture, and enacting ergonomic policies at the organizational level.
Our findings demonstrate the complexity of the work system that goes well beyond these individual factors and highlight the need for interventions that consider the entire work system, including organizational and administrative supports. For example, among seven widely recommended organizational ergonomic practices and policies, respondents indicated an average of only two being in place at their place of employment. Similarly, one-third of the respondents had reported an issue or concern, only one-quarter of whom experienced a satisfactory resolution to their concern. Examining these factors within specific practice areas (e.g., obstetrics, echocardiography) led to identifying unique SWS components associated with risk or protection from experiencing work-related discomfort. Specifically, sonography work processes, including hand use during scanning tasks (i.e., left/right/ambidextrous) and workflow interruptions, had significant associations with discomfort.
Implications: Most previous interventions in this healthcare worker population have been targeted at equipment design and individual worker training in ergonomics. Using the SWS to contextualize sonographer worker health within this broader system provides a research framework and a visual model for developing interventions. Through further longitudinal study of the sonography cohort, we will continue to apply the SWS factor to gain a holistic understanding of the complex problem of sonographer worker health. This model for examining worker health and well-being using a sociotechnical systems framework may be useful for robust identification of key associations between the worker, work, and workplace system within a variety of healthcare worker populations.
Methods: The Systems Engineering Initiative for Patient Safety (SEIPS) framework is one of the leading sociotechnical systems models that provides a useful foundation for identifying these critical factors. Although the worker is included as a component of the work system within the SEIPS model, this model primarily focuses on patient safety and organizational-level outcomes. Using the SEIPS as a foundational framework, we developed the Sonography Work Systems (SWS) model to focus on worker health and well-being outcomes that then influence the system with the sonographer located at the center of the critical relationships among the work systems factors and the performance of work processes. To examine the utility of our SWS model, we conducted a national workforce survey to explore associations among personal, physical, social, and organizational work system factors and sonography work processes with worker health outcomes.
Results: Using logistic regression analyses, we identified associations and interactions between the worker-work-workplace system components within a representative sample of 3659 sonographers. In our sample, 86% of sonographers reported work-related discomfort, and nearly half of the sample reported regularly experiencing headaches and visual strain associated with their work. Multiple work systems factors contributed to a final model of protection from physical discomfort, including using adjustable equipment, regularly taking work breaks, having a positive workplace culture, and enacting ergonomic policies at the organizational level.
Our findings demonstrate the complexity of the work system that goes well beyond these individual factors and highlight the need for interventions that consider the entire work system, including organizational and administrative supports. For example, among seven widely recommended organizational ergonomic practices and policies, respondents indicated an average of only two being in place at their place of employment. Similarly, one-third of the respondents had reported an issue or concern, only one-quarter of whom experienced a satisfactory resolution to their concern. Examining these factors within specific practice areas (e.g., obstetrics, echocardiography) led to identifying unique SWS components associated with risk or protection from experiencing work-related discomfort. Specifically, sonography work processes, including hand use during scanning tasks (i.e., left/right/ambidextrous) and workflow interruptions, had significant associations with discomfort.
Implications: Most previous interventions in this healthcare worker population have been targeted at equipment design and individual worker training in ergonomics. Using the SWS to contextualize sonographer worker health within this broader system provides a research framework and a visual model for developing interventions. Through further longitudinal study of the sonography cohort, we will continue to apply the SWS factor to gain a holistic understanding of the complex problem of sonographer worker health. This model for examining worker health and well-being using a sociotechnical systems framework may be useful for robust identification of key associations between the worker, work, and workplace system within a variety of healthcare worker populations.
Event Type
Poster Presentation
TimeTuesday, March 264:45pm - 6:15pm CDT
LocationSalon C
Digital Health
Simulation and Education
Hospital Environments
Medical and Drug Delivery Devices
Patient Safety Research and Initiatives